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This allergic reaction of the skin occurs to a substance which comes in contact with the surface of the skin. The antigens responsible for this type of dermatitis are simple chemical compounds present in the substances to which the patient is exposed during his daily activities.
Clothes, shoes and jewellery, lipsticks, hair dyes, local application, plants juices of vegetables and fruits or chemicals and tools employed in industries, factories and other professional activities are few of man substances that might cause this poblem.
Sometimes, components of plants or other agents suspended in the air can sensitise an individual and cause contact dermatitis without the patient being aware of a direct contact.
Clinically, the lesions consist of a dermatitic reaction which may be acute, subactue, or chronic, depending upon the nature of the antigenic substance and the degree of hypersensitivity of the individual.
As a general rule, volatile substances or liquid antigens produce an acute reaction which consists of severe itching, oedema, erythema, papules and papulo-vesicles, while solid antigens tend to produce a subacute reaction consisting of itchy erythematous and scaly areas.
On the palms and soles, this reaction usually consists of erythema and fissures. The dermatitic reaction is always limited to the areas of skin which come in contact with the antigen.
The best clue to the causative agent, lies in the distribution of the lesions on the body.
Treatment
Most important thing to do is to prevent further exposures of the patient to the causative agent.
Treatment of the acute attack consists of local compresses with saline or potassium permanganate, followed by local applications of a corticosteroid ointment with or without antibiotics.
For itching, oral antihistamine tablets a short course of systemic corticosteroids may be helpful in providing quick relief.
After the clinical manifestations have subsided and the systemic corticosteroids have been withdrawn, the patient should be subjected to patch test with the substances suspected to be responsible for his contact dermatitis to confirm the actual cause.
If it is not possible to avoid further exposures to the agent, the patient should be advised to use physical barriers or barrier creams which when applied on the skin, prevent the causative agent from entering the skin.
The barrier creams have to be applied at least two or three times a day on the skin areas which are likely to be exposed to the causative agent.
Whenever the skin area is washed or wiped, application of the barrier cream should be repeated.