WHO Model Prescribing Information: Drugs Used in Skin Diseases
(1997; 132 pages) [French] [Spanish] View the PDF document
Table of Contents
View the documentPreface
View the documentIntroduction
Open this folder and view contentsParasitic infections
Open this folder and view contentsInsect and arachnid bites and stings
Open this folder and view contentsSuperficial fungal infections
Open this folder and view contentsSubcutaneous fungal infections
Open this folder and view contentsBacterial infections
Open this folder and view contentsViral infections
Close this folderEczematous diseases
View the documentContact dermatitis
View the documentAtopic dermatitis
View the documentSeborrhoeic dermatitis
Open this folder and view contentsScaling diseases
Open this folder and view contentsPapulosquamous diseases
View the documentCutaneous reactions to drugs
Open this folder and view contentsPigmentary disorders
Open this folder and view contentsPremalignant lesions and malignant tumours
Open this folder and view contentsPhotodermatoses
Open this folder and view contentsBullous dermatoses
View the documentAlopecia areata
View the documentUrticaria
Open this folder and view contentsConditions common in children
View the documentAcne vulgaris
View the documentPruritus
View the documentTropical ulcers
Open this folder and view contentsAntimicrobial drugs
Open this folder and view contentsAntifugal drugs
Open this folder and view contentsAntiseptic agents
Open this folder and view contentsKeratoplastic and keratolytic agents
Open this folder and view contentsScabicides and pediculicides
Open this folder and view contentsAnti-inflammatory and antipruritic drugs1
Open this folder and view contentsAntiallergics and drugs used in anaphylaxis
Open this folder and view contentsUltraviolet radiation-blocking agents (sunscreens)
Open this folder and view contentsMiscellaneous drugs
Open this folder and view contentsAnnex
View the documentSelected WHO Publications of Related Interest
View the documentBack cover
 

Contact dermatitis

Both irritants and allergens can induce contact dermatitis. Non-allergic dermatitis sometimes follows isolated exposure to a strong irritant or, more frequently, is induced by repeated exposure to less potent chemicals, including soaps, detergents and solvents. The skin becomes dry, inelastic, fissured and secondarily infected through breaches in the protective stratum corneum.

Allergic contact dermatitis is a form of delayed hypersensitivity. It is, in part, genetically determined and results from exposure of a previously sensitized individual to an allergen. A vesicular or bullous eruption usually first develops at the site of primary contact but the allergen is frequently transferred by the hands to other parts of the body. The margins of the affected areas are often unnaturally sharp and angular. Inflamed, damaged or diseased skin is especially vulnerable, whereas the scalp, the palms of the hands, and the soles of the feet are protected by the greater thickness of the stratum corneum.

Plants, dyes, nickel and other metals, rubber, cosmetics and topical medicines are all potential allergens. Causative agents may be identified by patch testing, but the correct interpretation of such tests may be difficult. Sensitization to a component of a topically applied medicine is not uncommon and should be suspected if dermatitis develops following the application of a topical agent.

Prevention and management

Emollient creams accelerate healing and barrier creams may offer protection in the workplace. Patients should not use abrasive soaps and they should avoid, as far as possible, exposure to irritant substances.

Hydrocortisone 1% ointments or creams are of value in suppressing inflammation. More potent topical corticosteroids can also be used, but may not offer any better efficacy since the condition is usually self-limiting. The use of a short course of oral prednisolone or prednisone to suppress severe acute reactions associated with blistering, exudation and oedema should be considered. The oral corticosteroid can be given in successively lower doses over a 2-week period. Consultation with a dermatologist, if one is available, should be considered.

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