115 - Irritant contact dermatitis

Abstract

Irritant contact dermatitis (ICD) is the most common form of contact dermatitis and is defined as the reaction to an exogenous substance – the irritant – that damages the epidermis through physical or chemical mechanisms, triggering an innate immunologic response. Correct diagnosis is essential in the management of ICD. An evaluation should include patch testing to rule out allergic contact dermatitis, a family history (including history of atopy, psoriasis, or other skin conditions), and history of work, habits, hobbies, and exposures to determine the possible causative irritants. Once the irritant is identified, avoidance is key to treatment and prevention. However, even with avoidance, further treatment for ICD is often required. In this review, we provide a thorough evaluation of the literature regarding first-line (physical skin protection, emollients, moisturizers, barrier creams, topical corticosteroids, and topical calcineurin inhibitors), second-line (narrowband ultraviolet light therapy, dupilumab, methotrexate, hand psoralen plus UVA therapy, and ciclosporin), and third-line (alitretinoin/acitretin) treatments for ICD.