Fast Five Quiz: Common Rashes and Skin Irritations

William James, MD

Disclosures

November 19, 2021

The definitive treatment of contact dermatitis is the identification and removal of any potential causal agents. Topical corticosteroids are the mainstay of treatment for allergic contact dermatitis, and various symptomatic treatments can provide short-term relief of pruritus. Topical corticosteroids and immunomodulators are of unproven use in treating irritant contact dermatitis.

Acute severe allergic contact dermatitis, such as from poison ivy, often needs to be treated with a 2-week course of systemic corticosteroids. Most adults require an initial dose of 40-60 mg. The oral corticosteroid is tapered over a 2-week period, but a complicated tapering regimen probably is not necessary given the short duration of systemic corticosteroid use. However, long-term use of systemic corticosteroids to treat allergic contact dermatitis may produce severe morbidity. Individuals with allergic contact dermatitis should not receive long-term systemic corticosteroids or immunosuppressives unless extensive patch testing and evaluation have failed to identify remedial causes of the severe dermatitis.

Topical tacrolimus is an option in patients with allergic contact eyelid dermatitis that is not controlled by brief courses of class l or ll topical corticosteroids and allergen avoidance. Pimecrolimus is a topical treatment that may be helpful for mild allergic contact dermatitis of the face.

An inflammatory reaction from acute delayed irritant contact dermatitis to an agent such as benzalkonium chloride (eg, Zephiran) rarely needs treatment and usually resolves with cessation of exposure.

Learn more about the treatment of allergic contact dermatitis.

This Fast Five Quiz was excerpted and adapted from the Medscape Drugs & Diseases articles Atopic Dermatitis, Irritant Contact Dermatitis, Allergic Contact Dermatitis, and Seborrheic Dermatitis.

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