Irritant Contact Dermatitis (ICD)

Etiology: Acute or chronic/cumulative direct nonimmunologic inflammatory reaction to toxic injury, e.g., by chemical/irritant agents. Occurs in all individuals exposed to chemicals, given sufficient exposure times and concentrations; no previous exposure necessary.

History: Regular exposure to common irritants: water, soap, detergents, solvents, alcohol. Pain, burning, and stinging exceed pruritus early on. Those with history of atopic dermatitis are more susceptible.

Physical: Ill-defined erythematous, scaling, papulovesicular dermatitis; chronic—scaling lichenified dermatitis.

Investigations: Patch testing to rule out ACD.

DDx: Dermatitis—allergic contact atopic, nummular, seborrheic, stasis; cellulitis; drug reaction.

Management

Prevention: Avoid irritant exposure by use of barriers (gloves, barrier creams) and/or by using less irritating materials as substitutes.

Treatment: Liberal use of nonsensitizing moisturizers (e.g., plain petroleum jelly) +/- topical steroids.