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Contact Dermatitis

contact dermatitis

What is Contact Dermatitis (Contact Dermatitis)?

Contact dermatitis is inflammation of the skin caused by an external agent that comes into contact with the skin. Generally, one or more of the skin lesions such as itching, redness, scaling, crusting, skin cracks, water-filled blisters may be present together.

What causes contact dermatitis?

Contact dermatitis is classified into two groups according to its cause; It is irritant contact dermatitis, which occurs when the causative substance irritates the skin, and allergic contact dermatitis, which is caused by the body’s immune response to the allergen that comes into contact.

  • Irritant contact dermatitis: It occurs as a result of direct skin damage by a skin irritant such as detergents or solvents. These substances destroy the natural oil layer of the skin, which is protective, and first cause drying and peeling of the skin. Then it causes itchy eczema plaques, intense drying, skin cracking. The most common form is hand eczema, which is seen in housewives, but nurses, operating room workers, hairdressers, cleaning and catering workers, which are high-risk professions, are also at risk.

Allergic contact dermatitis: Allergic contact dermatitis occurs when the allergen that comes into contact with the skin develops a hypersensitivity reaction. These substances can be rubber, hair dye, perfumes, cosmetics, metals. This type of dermatitis does not develop in everyone and does not occur on the first encounter. The person must have had contact with this substance before.

What are the symptoms of contact dermatitis?

Contact dermatitis begins with burning, itching and redness, especially where the suspected agent has come into contact with. Bubbles that collect water in the contact area, tissue swelling, drying, dandruff and skin thickening may occur in the future. While irritant contact dermatitis is confined to the area of ​​contact with the substance, allergic contact dermatitis can spread throughout the body.

The hands are most commonly affected by eczema. Skin cracks, thick dandruff and dryness on the hands, especially on the fingertips and palms, are the main symptoms. In allergic hand eczema, tiny water bubbles can be seen on the inside of the fingers. Allergies to cosmetic products tend to occur in folds such as eyelids and face, hair dye allergy forehead, nape and back of the ear, glove allergy hands and wrists, textile allergy armpits and groin areas.

How is contact dermatitis diagnosed?

The diagnosis is made by the patient’s history (anamnesis), physical examination findings and patch test. In irritant contact dermatitis, the history of contact with irritants and the appearance of eczema on the contacted areas are sufficient to make the diagnosis. In allergic contact dermatitis, an allergy test called a skin patch test is used to find the allergen causing it.

In this test, boxes containing allergens are attached to the back with tape and kept on the back for two days. After two days, the bands are removed, the test is evaluated on the 2nd and 3rd days, and if there is an allergen that can be found, the patient is recommended to avoid this substance.

How is contact dermatitis treated?

The main treatment in contact dermatitis is avoidance of the eczema-causing agent. Strengthening the acid mantle, which acts as a barrier to the skin by moisturizing the skin, is the most important protective and therapeutic step. It is important to use protective gloves and not to use irritating cleaners such as soap detergents.

If the detected substance is in the workplace, protective measures or a change of department at work are recommended. Topical steroids (cortisone creams) and moisturizers are the first line of treatment. Topical steroids should be used as recommended by the physician and for the duration. In severe cases of contact dermatitis, cortisone treatments, either by mouth or by injection, may be required.

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