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Contact dermatitis is commonly prevalent skin disorder which forms erythematous and itchy dermal lesions. There is almost always a history of contact with a foreign agent or substance. Categorically, contact dermatitis is divided into irritant and allergic type. The former is manifested by non-immune mediated skin irritation while the latter is caused by delayed type hypersensitivity reaction as soon as a foreign agent is contacted with the skin. The most common etiologic agents involved in contact dermatitis are poison ivy, certain fragrances and nickel.
Usual symptoms of contact dermatitis include scaly and erythematous skin lesions with severe pruritis. In acute cases, the lesions develop flare ups with vesicle and bullae formation while, in chronic cases, there is appearance of lichen fissures and cracks.
The disease is generally well addressed by use of topical steroids of varied potency, several times each day. These steroids may be triamcinolone or clobetasol of 0.1% and 0.05% potency respectively. If the affected area exceeds 20% of total area, then systemic steroid can be used in a justified dosage. The therapeutic effect is achieved within 12 to 24 hours. In more severe cases, oral prednisolone can be continued for over a period of two to three weeks in tapered doses. In refractory cases, patch test should be done to withdraw the stimulant.
The article is very well written and encompasses all the essential information for the diagnosis, symptoms and management of contact dermatitis. Due to its commonness, it is often misdiagnosed which makes the treatment difficult. However, it is recommended that the above mentioned treatment protocol should be followed to address contact dermatitis.
Usatine, R., & Riojas, M. (2010). Diagnosis and Management of Contact Dermatitis. American Family Physician, 82(3), 249. Retrieved from http://www.aafp.org/afp/2010/0801/p249.pdf