Irritant contact dermatitis

    Article Contributors: 
    Sean Klepper M.D.
    Artur Zembowicz M.D....

    Clinical Features:

    • Caused by direct damage to the skin by physical or chemical substances
    • Clinically indistinguishable from allergic contact dermatitis, the distinction being made on the basis of history and skin allergen testing
    • Unlike in allergic contact dermatits, no prior sensitization is required.
    • Common inciting agents include those encountered through occupational exposure, such as detergents and motor oil
    • Acute irritant dermatitis presents with scaling, erythema, vesicles or erosions. 
    • Chronic irritant dermatitis presents with dryness and chapping without vesicles.

    Histologic Features:

    • The histologic features are basically identical to those of allergic contact dermatitis:
      • Spongiosis with intraepidermal vesicle formation
      • Dermal edema
      • Irregular psoriasiform hyperplasia (in subacute and chronic lesions)
      • Upper dermal perivascular lymphocytic infiltrate
    • Features that may be more prominent in irritant than in allergic contact dermatitis are:
      • Epidermal necrosis
      • Neutophils
      • Acantholysis
    • Features that may be present in allergic contact dermatitis but that are usually absent from irritant contact dermatitis are:
      • Eosinophils
      • Langerhans cell clusters
      • Extensive exocytosis of lymphocytes
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    Cases associated with this book:

  • Irritant contact dermatitis
    Author: Artur Zembowicz M.D. Ph.D.

    Conference: Teaching Collection