25 - Irritant Dermatitis Flashcards
Y/N: Irritant contact dermatitis predispose patients to developing atopic and allergic contact dermatitis.
Yes
Irritant chemicals by definition do not cause scarring when in contact with the skin for less than
4 hours
Y/N: When acute, irritant and allergic contact dermatitis cannot be reliably differentiated clinically or histologically.
No - When chronic
Patient history is very helpful when distinguishing acute irritant dermatitis from acute allergic contact dermatitis.
(Women/Men) are more likely to have hand dermatitis
Women
ACD/ICD: Sharp, strictly confined to the site of exposure
ICD
ACD/ICD: Evolves 12-72 hours after exposure
ACD
Most important irritant that provokes irritant dermatitis
Water
Y/N: Oil dermatitis is characterized by perifollicular papules and pustules.
Yes
ACD/ICD: Epidermal disruption is the primary finding.
ICD
ACD/ICD: Displays proportionately more dermal inflammatory infiltrate.
ACD
ACD/ICD: Flexural accentuation is an important sign.
ICD
Retinoid dermatitis preferentially involves
Folds such as the nasolabial fold
Y/N: Hand dermatitis always has an irritant component.
Yes
Pathogenesis of ICD (3 steps)
- Epidermal insult
- Danger signals
- Potential for allergic sensitization
Damaged keratinocytes release danger signals termed
Alarmins
Innate signal from disrupted skin barrier, together with the irritant signal of a potent antigen, may drive dendritic cells into the dermis and promote
Immunologic tolerance
Example: Patients with atopic dermatitis are less likely to exhibit dermatitis to the potent allergen in poison ivy that is also a strong irritant.
If initial food exposure is on _____, tolerance develops.
Mucosa
Measure of the ability of the skin to maintain homeostasis of fluids
Transepidermal water loss
Has been studied to help differentiate irritant from allergic contact dermatitis in vivo, but is not currently used in practice
Confocal microscopy
Most allergens on standard screening tests are _____ potency allergens
Strong or medium
Irritant dermatitis often resolves despite continued exposure to the irritant; this is known as
Hardening
Suggest that _____ replace the term barrier cream
Prework cream
Topical corticosteroids are frequently used, but chronic use may impair barrier function by
Thinning the epidermis
Considered second-line therapy for chronic hand dermatitis in Europe
Alitretinoin
Should substitute for hand washing especially in cold seasons
Alcohol-based hand sanitizers
Cotton gloves are recommended under occlusive gloves if the duration of glove usage is longer than
10 minutes
Y/N: Acute dermatitis has a worse prognosis than chronic dermatitis.
No - chronic dermatitis had a worse prognosis
