Dermatitis

 Dermatitis is derived from a Greek word, ‘derma’ means ‘skin’ and ‘it is’
means inflammation of skin. Eczema ‘Ec’ means ‘out’ ‘zoo’ means boil
meaning bailout. The two terms “Dermatitis” and “Eczema” are being
used simultaneously by most dermatologists.However,dermatitis is
acute condition and eczema is a chronic condition.

 Dermatitis is non-contagious superficial inflammation of upper layer of

skin characterized by erythema,oedema,oozing,vasculization,crusting
scaling and lichenification.
 Contact Dermatitis

 Contact dermatitis is a red, itchy rash caused by direct contact with a substance or
an allergic reaction to it. It is a type of delayed hypersensitivity reaction. The rash
isn't contagious or life-threatening, but it can be very uncomfortable.
 Classification

There are four basic types: allergic, irritant, phototoxic, and photoallergic.

Allergic dermatitis. Allergic dermatitis results from direct contact with substances called
allergens.

 Common allergens include:

 Nickel, which is used in jewelry, buckles and many
other items
 Medications, such as antibiotic creams and oral
antihistamines
 Formaldehyde, which is in preservatives, disinfectants
and clothing
 Personal care products, such as deodorants, body
washes, hair dyes, cosmetics and nail polish
 Airborne substances, such as ragweed pollen and spray
insecticides
Irritant contact dermatitis. Irritant contact dermatitis develops when your skin comes into contact
with an irritating substance.

Common irritants include:

 Solvents
 Rubbing alcohol
 Bleach and detergents
 Shampoos, permanent wave solutions
 Airborne substances, such as sawdust or wool dust
 Plants


Phototoxic contact dermatitis. Phototoxic contact dermatitis is a sunburn-like skin disorder resulting
from direct tissue damage following the ultraviolet light-induced activation of a phototoxic agent.

Photoallergic contact dermatitis. Photoallergic contact dermatitis is a delayed-type hypersensitivity

cutaneous reaction in response to a photoantigen applies to the skin in subjects previously
sensitized to the same substance.
 Pathophysiology
The pathophysiology of contact dermatitis involves pathogens that irritate the skin.

 Binding. The hapten (small hydrophobic molecules)-protein complex enters the stratum
corneum and binds to epidermal antigen-presenting Langerhans cells.

 Deception. These cells process the antigen and travel to regional lymph nodes where they
present the antigen to naive CD4 T cells.

 Proliferation. These T cells then proliferate into memory and effector T cells, which elicit
contact dermatitis within 48 to 96 hours of reexposure to the allergen.
 Symptoms
Signs and symptoms of contact dermatitis include:
 Itching, which may be severe
 A red rash
 Dry cracked, scaly skin
 Bumps and blisters, sometimes with oozing and
crusting
• Swelling, burning or tenderness

Contact dermatitis on the face

 Complications
Contact dermatitis could lead to the following complications

 Chronic itchy, scaly skin. A skin condition

called neurodermatitis starts with a patch of itchy skin, which,
when scratched habitually, may result in a thick,leathery, and
discolored skin.

 Infection. If a rash is scratched habitually, it may turn into an open

wound wherein bacteria could enter and cause infection.
 Diagnostic Findings
Patch test. Patch test on the skin with suspected offending agents may
clarify the diagnosis.

Fig. patch test

 Medical Management
The most important step in the medical management of dermatitis is to recognize the causative
factor so that it could be avoided.

 Avoiding the irritant. The key is to identify the substance that causes the rash so that it could
be avoided.

 Phototherapy. There are patients that need light therapy to calm their immune system, and the
method is called phototherapy.

 Medicated baths. Medicated baths are prescribed for larger areas of dermatitis.
 Pharamacologic Therapy
Drug therapy for contact dermatitis usually consists of lotion, creams, and oral medications.

 Hydrocortisone, a corticosteroid, may be prescribed to combat inflammation in a localized

area.

 Antihistamines. Prescription antihistamines may be given if non-prescription strength is

inadequate.

 Barrier cream. These products can provide a protective layer for the skin.
 Antibiotics. Topical or oral antibiotics may be used to treat secondary infection.
 Nursing Interventions
Nursing interventions appropriate for the patient include:

 Skin care. Encourage the patient to bathe in warm water using a mild soap, then air dry the skin and gently pat to
dry.
• Topical application. Usual application of topical steroid creams and ointments is twice a day, spread thinly and
sparingly.
• Phototherapy preparation. Prepare the patient for phototherapy, because this method uses ultraviolet A or B light
waves to promote healing of the skin.
• Acknowledge patient’s feelings. Allow patient to verbalize feelings regarding their skin condition.
• Proper hygiene. Encourage the patient to keep the skin clean, dry, and well lubricated to reduce skin trauma and
risk for infection.
Thankyou!!!