Irritant contact dermatitis is a reaction caused by direct physical or chemical injury to the epidermis. The damage caused by an irritant leads to inflammation, manifested in the skin as erythema, edema, and scaling. Irritant contact dermatitis should be differentiated from true allergic contact dermatitis, which is a delayed type-IV hypersensitivity (immune) reaction.
Contact dermatitis of the vulva is more often of the irritant type, rather than allergic, due to the persistent moisture and maceration in the genital region.
Soaps, detergents, antiseptic solutions, and topical medications are often the source of irritation. Prolonged or recurrent exposure to an irritant often causes the skin to become lichenified, hyperkeratotic, and inflamed.
Early in the course of irritant contact dermatitis, patients typically present complaining of a burning or stinging; the symptoms and skin eruption usually follow the exposure by hours if the irritant is strong (whereas in allergic contact dermatitis, symptoms are usually delayed by approximately 2 days following exposure). As the irritation becomes chronic and the skin continually inflamed, pruritus can become a predominant symptom.
Irritant contact dermatitis - Anogenital in
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Synopsis
Codes
ICD10CM:
L24.9 – Irritant contact dermatitis, unspecified cause
SNOMEDCT:
110979008 – Primary irritant dermatitis
L24.9 – Irritant contact dermatitis, unspecified cause
SNOMEDCT:
110979008 – Primary irritant dermatitis
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Irritant contact dermatitis can often be misdiagnosed for allergic contact dermatitis (allergic CD) or contact urticaria. The reaction with contact urticaria will occur in minutes to hours whereas the contact dermatitis takes 24-48 hours. Allergic CD tends to have a more vigorous response than irritant CD does. Patients often have blisters, exudate, edema, and erythema with an allergic reaction. With an irritation reaction, usually only erythema, edema, and a raw, burning sensation are present.
- Lichen simplex chronicus – can develop as a complication of chronic pruritus
- Seborrheic dermatitis
- Atopic dermatitis
- Genital herpes simplex
- Cellulitis
- Psoriasis
- Lichen planus
- Bowenoid papulosis
- Bowen disease
- Extramammary Paget disease
- Tinea cruris
- Candidiasis
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:08/13/2017
Last Updated:08/15/2017
Last Updated:08/15/2017
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Irritant contact dermatitis - Anogenital in
See also in: Overview,External and Internal Eye