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| | | |  Home  Disease Index Contact dermatitis
treatment of dermatitis, dermatitis causes, dermatitis psoriasis, contact dermatitis treatment, allergic contact dermatitis, irritant contact dermatitis Treat treatment of dermatitis, dermatitis causes, dermatitis psoriasis not responding to prescription drugs, scientifically - DrRaoMD cause contact dermatitis, vaginal contact dermatitis, treating contact dermatitis, contact dermatitis irritant syndrome |  Our Philosophy |
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 | Overview |
| | is inflammation of the skin that results from contact of an external substance with the skin. This can occur through one of two mechanisms: irritant or allergic. Irritant Irritants cause approximately 80 per cent of cases of . An irritant reaction is caused by the direct effect of an irritant substance on the skin. An irritant substance is one that would cause an inflammatory reaction in most individuals when applied in sufficient concentration for an adequate amount of time. Irritants are often encountered at work (occupational) although other common irritants are soaps, detergents, food and cement. Almost all workers in wet-work industries, such as hairdressing, cleaning, metal engineering, building-site work and horticulture develop some degree of irritant . Both sexes are equally susceptible to . Those with dry skins or who have one or more of the 'atopic' conditions (eczema, asthma or hay fever) are more likely to develop an irritant contact dermatitis. An irritant dermatitis is most likely to occur on the hands. Allergic contact dermatitis accounts for the remaining 20 per cent of cases. In this condition, the cause of skin inflammation is a hypersensitivity reaction, acting through the body's immune system, to a particular substance or group of related substances. dermatitis has the following features: previous exposure to the substance is needed to induce allergy. the reaction is specific to one chemical or a group of similar chemicals. all areas of skin that are in contact with the allergy-provoking substance (allergen) develop the rash. avoidance of the allergen will result in resolution of the rash.
The commonest allergens are: As with the irritant type, allergic is more common in atopic individuals. |
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| Causes |
| | Irritant Irritants cause direct injury to the skin. This can occur over a short (acute) or long (chronic) period of time. Acute irritant A single exposure to a substance causes an acute dermatitis, within minutes to hours after exposure. The course of events is: irritant substance penetrates the skin. substance damages the membranes of skin cells. cell damage prompts release of chemicals that trigger the immune system into action. This is called an inflammatory response. The chemicals involved (inflammatory mediators) include lysozymes, prostaglandins, histamine and kinins. some inflammatory mediators cause increased blood flow while others attract further inflammatory mediators.
Chronic irritant This is due to multiple exposures, often to several irritants at low levels over time. This can take many months or years to appear. The course of events is: each exposure adds to the gradual disruption of the outer layer of skin. each time, inflammatory mediators are released. the top layer of skin (epidermis) gradually thickens. the lipid (fat) layer in skin is gradually damaged. affected skin loses its ability to function as a barrier, so further exposure to an irritant produces further damage, and a 'vicious cycle' ensues. the final result is dryness, scaling and thickening of the skin.
This is a type of immune reaction known as 'type IV' or 'delayed hypersensitivity' reaction. The characteristic feature of this immune response is a delay between first exposure to an allergen and the subsequent reaction. It, therefore, occurs in two stages, sensitisation and elicitation. This starts with the substance penetrating the skin, which then binds to Langerhans' cells (a type of skin immune cell), which then leave the skin and travel to lymph nodes (glands) nearby. Here, the allergen is shown to another type of immune cell, T-lymphocytes, which proliferate and produce 'memory' cells that can remember that particular allergen. Once sensitisation has occurred, subsequent exposure to the allergen causes the T-lymphocytes to recognise the allergen, which activates them and causes them to multiply. Inflammatory mediators are released that induce the features of inflammation and bring more T-lymphocytes to the site of exposure. This ongoing immune reaction results in the eczema-like inflammation of the skin at the site of contact. This phase occurs within 48-72 hours after exposure. Small amounts of allergen can be enough to cause an inflammatory reaction. |
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| Symptoms |
| | The appearance of acute irritant dermatitis can range from a mild reaction consisting of transient redness to a severe painful burn with blistering. Chronic irritant dermatitis often begins with a few patches of dry, slightly inflamed skin that become thickened with time. Allergic contact dermatitis The features of eczema develop at the site of contact. For example, the first sign may be an itch under an earring or along a waistband that contains rubber. The itch can develop into an area of redness with swelling and even small blisters that weep. In contrast to irritant contact dermatitis, the reaction can extend beyond or occur in a different place from the site of contact. Occasionally, the appearance is that of urticaria (severely itchy raised red patches or wheals that can resemble insect bites, although these may be more irregular in shape). Rarely, swelling of the mouth and upper airways can occur, which is known as angioedema. This is serious and needs urgent medical attention. If exposure to an allergen persists, the skin becomes drier, thicker and more scaly with a change in the pigmentation (colour). |
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