Irritant contact dermatitis in Adult
See also in: External and Internal Eye,AnogenitalAlerts and Notices
Synopsis
The hands are the most common location for irritant contact dermatitis, although any body surface may be involved, including the genitals. Eyelid areas are also easily affected due to the very thin skin of the region and the unwitting transmission of irritant substances by the hands. Patients with a history of atopic dermatitis are particularly predisposed. Environmental factors include repeated exposure to water or frequent hand washing, soaps and solvents, fiberglass, mild acids, and alkalis. Dry air can also predispose to irritant contact dermatitis. Exposures are frequently occupational. High-risk jobs include cleaning, health care, food preparation, and hairdressing. Irritant contact dermatitis can occur at any age. It is more common in women.
Related topic: Hand dermatitis
Codes
ICD10CM: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
- Allergic contact dermatitis
- Atopic dermatitis
- Nummular dermatitis (nummular eczema)
- Dyshidrotic dermatitis (dyshidrotic eczema)
- Stasis dermatitis
- Phytophotodermatitis
- Intertrigo if present in skin fold
- Tinea corporis – When a patient presents with scaling lesions (especially on the hands or feet), it is important to perform a potassium hydroxide (KOH) preparation to rule out a fungal etiology.
- Psoriasis
- Pityriasis rosea
- Seborrheic dermatitis – The distribution of lesions is often a helpful clue in distinguishing this entity from atopic dermatitis.
- Lichen simplex chronicus
- Scabies
- Cellulitis
- Erysipelas
- Herpes simplex virus infection
- Impetigo
- Cutaneous T-cell lymphoma / mycosis fungoides – If an adult patient has persistent "eczema" that is not adequately responding to therapy, this entity should be ruled out with skin biopsies.
- Glucagonoma syndrome
- Pellagra
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.Subscription Required
References
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Last Reviewed:10/17/2017
Last Updated:12/03/2017
Last Updated:12/03/2017
Irritant contact dermatitis in Adult
See also in: External and Internal Eye,Anogenital