Clinical aspects of irritant contact dermatitis

Abstract

Irritant contact dermatitis (ICD) is more common than allergic contact dermatitis (ACD). It ranges from acute irritant reactions to chronic forms, often morphologically indistinguishable from ACD. Numerous exogenous and endogenous factors are involved in the pathogenesis. Major irritants are water, detergents, acidic and alkaline substances of various nature. Mechanical and thermal influences are important cofactors. Sensitive skin does exist and is frequently associated with previous atopic dermatitis. Chronic ICD is a diagnostic challenge and may be complicated by secondary sensitization to environmental allergens. Therapy and prevention require identification of irritants and reduction of skin contact by gloves or technical measures. Some topical medications and skin care products (e.g., sunscreens) may cause subjective discomfort without clinical signs of irritation: sharp stinging pain or burning of the skin develop several minutes after application in a crescendo pattern. This is considered to be a special form of neurosensory irritation © 2011 Springer-Verlag Berlin Heidelberg.