Article Sections

Introduction

Contact dermatitis is an inflammatory skin condition caused by exposure to an irritant that disrupts the skin barrier (irritant contact dermatitis [ICD]) or to an allergen that causes a type IV (delayed-type) hypersensitivity reaction (allergic contact dermatitis [ACD]).  ICD and ACD have overlapping clinical presentations, virtually indistinguishable histologic features, and similar management strategies.

Pathophysiology

Irritant contact dermatitis (ICD)

Chemical (eg, water, detergents, solvents) or physical (eg, metals, wood, fiberglass) irritants can disrupt the epidermal barrier through damage (eg, microtrauma) to keratinocytes, increasing epidermal permeability and water loss.  A nonspecific inflammatory response follows at the site of exposure, likely caused by the activation of innate immunity and the release of cytokines from keratinocytes.

Allergic contact dermatitis (ACD)

ACD is a type IV (delayed-type)

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