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Contact dermatitis occurs when specific or toxic substances come into contact with the skin and causes a rash. This can be due to either irritation or a delayed hypersensitivity type of allergic reaction. Contact dermatitis can cause mild to severe skin irritation, inflammation and itchiness.
Irritant contact dermatitis happens when the substances damage the contacted skin it touches. These types of reactions can appear anywhere but commonly occur on the hands after an individual has handled something that causes a non-allergic inflammatory response.
Allergic contact dermatitis occurs when a chemical or other substance causes a red, itchy, bumpy reaction on the skin due to a delayed hypersensitivity allergic response. Examples of substances that can cause these type reactions include poison ivy, perfumes, dyes, latex, metals, especially nickel. This type of reaction normally starts 24-48 hours after initial contact.
Contact dermatitis is diagnosed by its appearance and a careful medical history. Offending agents can sometimes be identified based on the timing of onset of the rash. Other times the causes are more elusive. Allergist can conduct patch testing where suspected offending agents are taped to the skin for 24 hours then removed. The test area is then observed for next 1-5 days looking for skin reactions..
Acutely corticosteroids are the mainstay of treatment, given both orally or as an injection. Antihistamines can help with skin itching. Identification of the offending agent allows the patient to practice avoidance which prevents future reactions.