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Dermatitis - contact - Making a diagnosis
History
- In acute allergic contact dermatitis:
- The main symptoms are redness, itch, and scaling.
- Reaction after contact occurs after a delay of many hours to several days.
- Location of the dermatitis is helpful in identifying the cause (e.g. dermatitis from cosmetics on eyelids and cheeks). However, it may affect areas not directly in contact with the allergen.
- Resolution may take many days, with or without treatment.
- In irritant contact dermatitis:
- The main symptoms are burning, stinging, and soreness.
- The onset of reaction is usually within 48 hours. Strong irritants can produce immediate reactions, whereas mild irritants require prolonged or repeated exposure to cause a reaction.
- The rash only affects areas of skin exposed to the irritant.
- A history of exposure to friction, wet work, soap, detergents, organic or alkaline solvents, or environmental relative humidity less than 35% are key factors in supporting this diagnosis.
- Resolution often occurs within 96 hours of removal of the stimulus.
- Atopic eczema increases the risk of irritant contact dermatitis and is a common association.
- Atopic eczema is less strongly associated with allergic contact dermatitis.
[Dahl, 1988; Beltrani and Beltrani, 1997; Mark and Slavin, 2006]
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