Contact Dermatitis, Dermatitis, Eczema

What is Dermatitis?
Dermatitis (Eczema) is an inflammation of the upper layers of the skin, causing blisters, redness, swelling, oozing, scabbing, scaling and itching.
All forms of Dermatitis, with the exception of the Irritant form, may involve an allergic reaction and may be aggravated further by stress and other allergic substances (allergens / antigens) including food items.

Contact Dermatitis:
This condition may be caused by irritation or allergic reaction to a substance the skin comes in contact with. Consequently, Contact Dermatitis is either called Irritant Contact Dermatitis or Allergic Contact Dermatitis. Allergic Contact Dermatitis may develop anywhere within a period of two days or even longer. Rashes may develop showing small, itchy blisters (vesicles) which may ooze, crust and scale. The condition may take weeks or months to clear. Dermatitis may also become a chronic condition.

Common Causes of Allergic Contact Dermatitis:
Any substance - with the exception of clean, pure water - may trigger an allergic response.

The usual culprits may include:
Cosmetics;
Nickel;
Plants (poison ivy, poison oak, poison sumac, ragweed, primrose, etc.);
Pharmaceutical drugs in Creams and Ointments including: Antibiotics (penicillin, sulfonamides, neomycin, etc.), Antihistamines (diphenhydramine, promethazine, pyribenzamine), Anesthetics (benzocaine), Antiseptics (thimerosal), Antifungal ointments (one confirmed case known to the author);
Other drugs;
Industrial chemicals including: Tanning agents, Rubber accelerators and Antioxidants (used in gloves, shoes, etc.);
Fungal infections (may cause allergic reaction on hands).

Conventional Treatments of Contact Dermatitis may include:
1. Removal of offending substance.
2. Corticosteroid ointments (Hydrocotisone in a Hypo-allergenic base), creams or tablets
(Prednisone). Antihistamines may not be very effective but are sometimes taken at night if sleeping is a problem.

Other forms of Dermatitis:

Atopic Dermatitis:
Atopic Dermatitis is a chronic form usually with a history of allergies (hay fever, asthma, food allergies, genetic predisposition). Excessive antibodies may be present (immunoglobulin E, etc.)

Exfoliative Dermatitis:
Thickened, red and scaly skin over the entire body.
Examples of drugs that can cause the rash: Penicillins, antibiotics containing sulfa.

Eczema (Dermatitis):
The words 'Eczema' and 'Dermatitis' are now interchangeably used.

Originally, 'Eczema' referred only to a skin inflammation which had no (obvious) external cause; such a skin inflammation is now specifically called 'Endogenous Eczema' or 'Constitutional Eczema'.

Eczematous Dermatitis
Essentially, this is another term for Dermatitis (skin inflammation caused by external substance / irritant).

Dermatitis Herpetiformis:
Small, itching, burning blisters that can break out almost anywhere on the body as a result of an autoimmune disease that may be caused by gluten allergies. Celiac disease may be commonly found.

Related Conditions:

Blistering Disease:
A condition with eruptions of blisters as found in Dermatitis Herpetiformis which may be caused by an allergy to gluten. Other forms include Pemphigoid and Pemphigus.

Drug-induced rashes:
This includes rashes with or without intense itching that do not fit into the description of other related conditions.

Erythema Multiforme:
A red, itching, ring-like rash with purplish centers which grows rapidly and may also affect the mucous linings of mouth and nose.
The rash may be caused by Sulfonamides, Anticonvulsive drugs (Phenytoin), Cancer, Radiation therapy, Herpes simplex infections.
Conventional Treatments may include: Removal of the offending substance, Antihistamines, Analgesics, Corticosteroids.

Erythema Nodosum:
Red or purple nodules mainly on the shins which may hurt.
The condition may be caused by: Antibiotics, Tuberculosis, Streptococcal infections, Sarcoidosis.
Conventional Treatments may include: Removal of the offending substance, NSAISs (non-steroidal anti-inflammatory drugs), Oral corticosteroids.

Granuloma Annulare:
Raised, ring-like nodules which may develop on legs, feet, hands or fingers.
The condition may be caused by allergic reactions to the sun and drugs like oral contraceptives (the Pill; listed under Side-Effects with one confirmed case known to author).
Conventional Treatments may include: Removal of the offending substance, Corticosteroids.

Lichen Planus:
Small, raised lesions with a flat top which may be pink or purple.
This condition may be caused by a reaction to Sulfonamides or Anti-rheumatic drugs. Stress may aggrevate this condition.
Conventional Treatments may include: Removal of the offending substance, Antihistamines, Oral corticosteroids.

Localized Scratch Dermatitis:
Characterized by dry, scaling, dark, thick patches.

Nummular Dermatitis:
Dry skin with coin-shaped spots with blisters, scabs and scaling.

Pityriasis Rosea:
Characterized by a mild, pink rash with oval, flat spots.
No suggested conventional treatments.

Psoriasis:
In Psoriasis, skin cells accumulate in excess forming thick patches of skin. Characterized by scaly bumps and raised patches from small to large which may be silvery or red.
Forms of Psoriasis: Guttate Psoriasis, Inverse Psoriasis, Plaque Psoriasis and Pustular Psoriasis.
Psoriasis may be caused by: Antidepressant drugs, Antimalarial drugs, Antihypertensive drugs and drugs known as Beta blockers. A genetic predisposition may be assumed in some cases.
Conventional Treatments may include: Removal of the offending substance, Emollients (to soften the skin), Anthralin, Coal tar preparations, Calcipotriol and/or Corticosteroid creams.

Rosacea:
Pimples with redness on cheeks and forehead. Surrounding skin may appear red and puffy. The affected area may itch, burn or sting.
Conventional Treatments may include: Removal of the offending substance (such as Topical corticoteroids, alcohol, coffee, spicy food, sunlight).
Treatments may also include: Topical antibiotics, oral tetracycline and/or oral retinoid drugs.

Seborrheic Dermatitis:
Inflammation of upper layers of skin causing scales on scalp, face and other areas.

Stasis Dermatitis:
Characterized by chronic redness, swelling, scaling, resulting in dark, brown skin.

References:
The Merck Manual of Medical Information. Home ed. 1999.
Canadian Medical Association Complete Home Medical Guide. 2001.

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Contact Dermatitis / Eczema

Other forms of Dermatitis:

Related Conditions: