Allergic contact dermatitis (pediatric) - Anogenital in
Contact dermatitis can be due to either allergic or irritant causes.
Allergic contact dermatitis is a delayed hypersensitivity reaction (type IV cell-mediated reaction) of sensitized individuals. The reaction occurs 48-72 hours after exposure. In children, allergic contact dermatitis is more common after the age of 5, but younger children can become sensitized.
The most common allergens appear to be nickel, chromates, rubber chemicals, neomycin (an antibacterial), oxybenzone (sunscreens), and poison ivy or oak. Nickel is found in jewelry, belt buckles, and metal closures on clothing. Chromates are found in shoe leathers. Rubber chemicals are found in gloves, balloons, and elastic in garments. Neomycin is common in triple antibiotic first aid ointments such as Neosporin (and generic versions of Neosporin), as well as other combination preparations with other antibacterials and corticosteroids and other topical ointments, creams, and lotions. It may also be found in eye preparations, eardrops, and some vaccines. Poison ivy or oak can be found just about anywhere.
Irritant contact dermatitis is due to non-immunologic local exposure of the skin to an irritating substance. Common substances producing irritant contact dermatitis include harsh soaps, bleaches, detergents, solvents, acids, alkalis, fiberglass particles, baby oils with antiseptics, bubble baths, saliva, talcum, urine, feces, and other intestinal secretions. The severity of the dermatitis will depend on the strength of the irritant, the cumulative effect of repeated exposures to the skin, and the condition of the skin.
Related topic: Diaper irritant contact dermatitis
L23.9 – Allergic contact dermatitis, unspecified cause
40275004 – Contact dermatitis
- Tinea corporis
- Seborrheic dermatitis – Less pruritic, localized to seborrheic areas.
- Irritant contact dermatitis – History of irritant exposure, resolves with low-to-mid potency steroids and gentle skin care.
- Atopic dermatitis – History of atopy, characteristic location of lesions (flexures, face, and acral extremities).
- Impetigo – Flaccid bullae, honey-colored crust, with ill-defined, non-geometric borders.
- Cellulitis is accompanied by pain, fever, and systemic symptoms.