Dermatitis Kontak: DR Putra Hendra SPPD Uniba

Dermatitis kontak
dr Putra Hendra SpPD

UNIBA
What Is Dermatitis ?
Dermatitis is the inflammation of
the skin caused by factors such
as:
Allergies
Irritants
Ultraviolet light
Foods
Medications
Hereditary
Pathogenesis of Dermatitis
Irritants Allergens Infection

type 1&4
Endogenous factors
Regional Sites of Predilection
4
What is contact dermatitis?
A disease involving inflammation

of
the skin
Caused by damage to the
skin by substances such
as solvents, wet work and
cleaners
Some substances cause
sensitization
What is contact dermatitis like?
Inflammation of the skin leading

to
Redness
Itching
Scaling / flaking
Blistering
Weeping
Cracking
Pain
What causes irritant contact dermatitis?
Chemical
Detergents
Solvents
Wet work
Pot washing
Wet food preparation
Types of Contact Dermatitis
Irritant Contact Dermatitis
An inflammatory reaction in the skin resulting
from exposure to a substance that causes an
eruption in most people who come in contact
with it
Allergic Contact Dermatitis
An acquired delayed sensitivity to various
substances that produce inflammatory
reactions in only those who have been
previously sensitized to the allergen
8
Pathogenesis
The irritants cause cell damage if applied
for sufficient time and in adequate
concentration. Inflammatory response
occurs because of the inability of the skin
to defend and repair its integrity and
function from penetrating chemicals.
9
Etiologic Agents
Water, soaps, detergents, bleaches, lye, drain pipe
cleaners, toilet bowl and oven cleansers
Acids and Alkalis
Solvents and Hydrocarbons
Fiberglass, dust, capsaicin, teargas, metal salts
Predisposing Factors
History of atopic dermatitis
Occupational exposure/ Repeated exposure
Low temperature/ Low humidity
Condition of the skin 10
Irritant contact dermatitis
Skin damaged directly by the irritant
soaps, detergents, water, solvents, dry
atmosphere etc
very, very common
atleast 5% of the population suffer from
hand dermatitis
Treat with emollients/moisturisers
Contact Dermatitis
The generic term applied to acute and chronic inflammatory
reactions to substances that come in contact with the skin
Acute dermatitis: pruritus, erythema, and vesiculation
Chronic dermatitis: pruritus, xerosis, lichenification,
hyperkeratosis, and/or fissuring
12
Irritant contact dermatitis occurs when chemicals or physical agents damage
the surface of the skin faster than the skin is able to repair the damage.
Irritants include such everyday things as water, detergents, solvents, acids,

alkalis, adhesives, metalworking fluids and friction.
47-year-old housekeeper
was the result of chronic
hand washing combined
with surfactant and other
solvent exposures
Acute Irritant Contact Dermatitis
14
15
16
17
Chronic Irritant Contact Dermatitis
Prolonged and repeated exposures of the skin to
irritants results to a chronic disturbance of the
barrier function, subsequently, elicit a chronic
inflammatory response.
Stinging and itching, pain as fissures develop
LESION
Dryness chapping erythema hyperkeratosis
and scaling fissures and crusting
Lichenification, vesicles, pustules, and erosions
18
Chronic Irritant Contact
Dermatitis
19
Acute Allergic Contact Dermatitis
Well-demarcated erythema and edema on
which are superimposed closely spaced,
nonumbilicated vesicles, and/or papules
LESION:
Erythema Papules vesicles erosions
crusts scaling.
21
Pathogenesis
22
23
24
Chronic Allergic Contact Dermatitis
25
26
Tests for Sensitivity
Provocative Use Test
Confirms a positive closed patch test reaction
to ingredients of a substance; to test products
that are made to stay on the skin once applied
Photopatch Test
To evaluate for contact photoallergy to such
substances as sulfonamides, phenothiazines,
PABA, oxybenzone, musk ambrette
27
Tests for Sensitivity
PATCH TEST
To detect hypersensitivity to a substance that is in
contact with skin so that the allergen may be
determined and corrective measures taken
28
How to prevent contact dermatitis?
Avoid contact
Protect your skin
Check for early signs of

dermatitis
Avoid skin contact
No contact No dermatitis
Make people aware of dermatitis
and its causes
Where possible
Use automation (eg. mixing or peeling)
Handle food with tools (eg tongs)
Buy in ready prepared ingredients
Use a dishwasher
Use tools for cleaning and pot
washing
Management for Contact Dermatitis
Prevention
Avoid exposure to potential allergen
Avoid repeated and prolonged exposure to
irritants
Wear protective clothing
Check skin reactions to cosmetics before
applying
31
Protect the skin
Re-usable Choose the correct size

gauntlets and suitable material
will be more Know how to put for individual and task
appropriate for them on and take
pot washing them off
Use a non latex Dispose of single

single use food use gloves after
grade glove for each use
wet food prep
Treatment for Irritant Contact
Dermatitis
Identify and remove the etiologic agent
Wet dressings with gauze soaked in Burow's
solution, changed every 2 to 3 hours
Larger vesicles may be drained, but tops should
not be removed
Topical class I glucocorticoid preparations
Severe cases: systemic glucocorticoids
Prednisone, 2-week course, 60 mg initially, tapering
by steps of 10 mg 33
Protect the skin
Take regular glove breaks

Wash contamination off the skin
Wash hands before and after glove use
Dry your hands thoroughly with a
soft paper towel
Use appropriate moisturizing creams
before and after work
Hypoallergenic, fragrance and nut oil free
Ensure all parts of the hands are covered
Contact Dermatitis
Acute -redness, itching, vesiculation
Chronic - scaly desquamation
Site and morphology determined by
causative exposure
Irritant - caustic agents or detergents
-hands
Allergic - rash 6-12 hours peaking at
48-72 hours
Etiologic Agents
Water, soaps, detergents, bleaches, lye, drain pipe
cleaners, toilet bowl and oven cleansers
Acids and Alkalis
Solvents and Hydrocarbons
Fiberglass, dust, capsaicin, teargas, metal salts
Predisposing Factors
History of atopic dermatitis
Occupational exposure/ Repeated exposure
Low temperature/ Low humidity
Condition of the skin 36
Etiologic Agents/Allergens
Poison Ivy, raw cashew nuts, mango, chrysanthemum,
pollens, castor bean, latex of fig and rubber trees
Fabric finishers, dyes, rubber additives, anti-wrinking and
crease-holding chemicals, brassieres, tight clothes
Rubber accelerators, leathers, adhesives, foam rubber
padding, felt, cork liners, formaldehyde in shoes
Nickel-containing (earrings, watch), Chromate (paint, gloves),
Mercury (waving solution, amalgams), Cobalt (paints, glass),
Arsenic (fabric dyes, disinfectants), Gold (dental gold, gold
jewelry contaminated with radon)
Fragrance, cosmetic preservatives, permanent hair dye, acid
permanent wave preparation, sunscreens, mechanical hair
removers, nail lacquers, deodorants 37
Well-demarcated erythema and edema on
which are superimposed closely spaced,
nonumbilicated vesicles, and/or papules
LESION:
Erythema Papules vesicles erosions
crusts scaling.
38
Plaques of lichenification (thickening of the
epidermis with deepening of the skin lines in
parallel or rhomboidal pattern), scaling with
satellite, small, firm, rounded or flat-topped
papules, excoriations, erythema, and
pigmentation
LESION
Papules scaling lichenification excoriations
39
How to prevent contact dermatitis?
Avoid contact
Protect your skin
Check for early signs of

dermatitis
Avoid skin contact
No contact No dermatitis
Make people aware of dermatitis
and its causes
Where possible
Use automation (eg. mixing or peeling)
Handle food with tools (eg tongs)
Buy in ready prepared ingredients
Use a dishwasher
Use tools for cleaning and pot
washing
Protect the skin
Re-usable Choose the correct size

gauntlets and suitable material
will be more Know how to put for individual and task
appropriate for them on and take
pot washing them off
Use a non latex Dispose of single

single use food use gloves after
grade glove for each use
wet food prep
Treatment for Allergic Contact Dermatitis
Identify and remove the etiologic agent.
Topical glucocorticoid ointments/gels (classes I to III)
for early nonbullous lesions
Larger vesicles may be drained, but tops should not
be removed
Wet dressings with cloths soaked in Burow's solution
changed every 2 to 3 hours
Systemic glucocorticoids: Severe & Exudative lesions
Prednisone,initial 70 mg (adults), tapering by 5 to 10
mg/d over a 1- to 2-week period. 43
Prevention
Avoid exposure to potential allergen
Avoid repeated and prolonged exposure to
irritants
Wear protective clothing
Check skin reactions to cosmetics before
applying
44

Dermatitis Kontak: DR Putra Hendra SPPD Uniba

Enviado por

Dados do documento

Título original

Direitos autorais

Formatos disponíveis

Compartilhar este documento

Compartilhar ou incorporar documento

Opções de compartilhamento

Você considera este documento útil?

Este conteúdo é inapropriado?

Direitos autorais:

Formatos disponíveis

Dermatitis Kontak: DR Putra Hendra SPPD Uniba

Enviado por

Direitos autorais:

Formatos disponíveis

Dermatitis kontak

dr Putra Hendra SpPD

Irritants Allergens Infection

A disease involving inflammation

Inflammation of the skin leading

Irritants include such everyday things as water, detergents, solvents, acids,

Protect your skin

Check for early signs of

Re-usable Choose the correct size

Use a non latex Dispose of single

Take regular glove breaks

Protect your skin

Check for early signs of

Re-usable Choose the correct size

Use a non latex Dispose of single

Você também pode gostar