-IBIS-1.5.0-
tx
cutaneous system
contact dermatitis/diaper rash
diagnoses

definition and etiology

definition:
skin irritation caused by primary chemical irritant or a delayed hypersensitivity reaction

etiology:
• contact dermatitis may be caused by exposure to petroleum distillates, soap, or other irritants; irritants can include plants (such as poison ivy), agents used in the manufacture of clothing and leather, metal compounds, dyes, cosmetics, and toiletries; some irritants require exposure to light to cause the reaction and are seen as the patient becomes suddenly more sensitive to sunlight; allergic dermatitis is often caused by the very applications used to treat skin irritations; antihistamines, antibiotics, and anesthetics may be used for several years before an allergic reaction develops
• diaper rash may be caused by alkalinity of stool or urine; there is also increasing empirical evidence that ingestion of foods to which the child is sensitive, particularly early administration of wheat and dairy, may result in idiosyncratic skin reactions to stool and urine which abate when the offending foods are removed

signs and symptoms

signs and symptoms:
• itching
• redness
• swelling
• papules
• vesicles, bullae
• weeping
• edema
• scaling, desquamation

Significant diagnostic clues may be obtained by examining the location of lesions, as these may suggest the likely irritant.

lab findings:
• immune globulins may be elevated for specific antigens

course and prognosis

Allergic dermatitis from delayed hypersensitivity may take days to develop. If the source of the irritation is removed, the symptoms usually disappear readily. If exposure is allowed to continue, further complications such as excoriations and infection of open sores may ensue.

differential diagnosis

• atopic dermatitis, psoriasis, seborrheic dermatitis etc.
• local infections, especially candida
• parasitic exposure
• emotionally initiated skin changes


footnotes