diagnosis

Last reviewed 01/2018

diagnosis

A diagnosis of irritant contact dermatitis can often be made with the clinical presentation and a careful history.

Consider inquiring about:

  • other 'allergies' eg. drug eruption
  • past history or family history of atopy
  • present and past occupations
  • hobbies, sparetime jobs
  • irritants and allergens used at home
  • time relationships - effects of season, weekend, holiday on the skin; interval between condition and contact
  • effects on other people exposed to same conditions

Acute exposure caused by potent agents may be recognised by the distinct distribution, location, and time of onset of skin changes after exposure to the causative agent.
The following diagnostic criteria can be helpful in making a diagnosis –


subjective

objective

major

minor

major

minor

onset - minutes to hours

onset <2 weeks

macular erythema, hyperkeratosis, or fissuring predominating over vesicular change

sharp circumspection of the dermis

symptoms -  pain, burning, stinging or discomfort exceeding itch

many people in the environment similarly affected

glazed, parched, or scalded appearance of the epidermis

evidence of gravitational influence, such as a dripping effect

 

 

the healing process proceeds without plateau upon withdrawal of exposure to substance in question

lack of tendency for spread of dermatitis

 

 

negative patch testing

vesicles juxtaposed closely to patches of erythema, erosions, bullae

No specific number of criteria is necessary; however, the more criteria that exist, the stronger the diagnosis 

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