Patients should avoid using topical antihistamines, including topical doxepin, because of the risk for iatrogenic allergic contact dermatitis to these agents; additionally, sedation can occur if large amounts of doxepin cream are applied.
Topical corticosteroids remain the mainstay of treatment, while various symptomatic treatments can provide short-term relief of pruritus. However, the definitive treatment of allergic contact dermatitis is the identification and removal of any potential causal agents; otherwise, the patient is at increased risk for chronic or recurrent dermatitis. Online resources allow the physician to create a list of products free of allergens to which the patient is allergic.
Large vesicles may benefit from therapeutic drainage (but not removing the vesicle tops). These lesions should then be covered with antibiotic dressing or a dressing soaked in Burow solution.
Many cases of localized mild contact dermatitis respond well to cool compresses and adequate wound care. Cool wet soaks applied for 5-10 minutes followed by air-drying may significantly reduce serous drainage from the site. Clean water, isotonic sodium chloride solution, and Burow solution can all be used with good success. Application of topical calamine is usually of minimal benefit.
For more on the treatment of contact dermatitis, read here.
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Cite this: William James. Fast Five Quiz: Compare Your Knowledge of Contact Dermatitis - Medscape - Jun 06, 2017.