Clinical features

Clinical manifestation of the condition may vary from mild skin dryness and erythema to more pronounced oedema, coalescing vesicles, bullae, pustules, ulceration and even skin necrosis (1)

Lesions are usually sharply demarcated and confined to the contact area (1)

• mild irritants such as soap or detergent causes dryness, itching, and cracking of the hands due to repetitive washing (2)

Symptoms include burning, stinging, and soreness of the skin (1)

• acute exposure - itchy, inflamed skin, usually red, swollen and papular with vesicles. Lesions develop rapidly within 6-12 hours of contact. Distant body sites less commonly affected. Recovery may be rapid if no further contact with the irritant
• chronic exposure - dry, irritable, red, scaly eruption. Hands and dorsal finger webs most commonly affected; hands are often cracked and fissured

Notes:

• due to its similarities in clinical and histopathologic presentations, differentiating irritant contact dermatitis from allergic contact dermatitis is difficult. Furthermore both condition often may coexist in a patient (1)
• irritant contact dermatitis risk is higher in patients with atopic eczema due to the impaired skin barrier function

References:

1. Eberting C.L, Blickenstaff N, Goldenberg, A. Pathophysiologic Treatment Approach to Irritant Contact Dermatitis. Curr Treat Options Allergy 2014; 1: 317
2. Rashid RS, Shim TN. Contact dermatitis. BMJ. 2016;353:i3299.