Eczema due to contact with an irritant

Aetiology

• Anyone may develop this, but at higher risk of skin barrier is compromised from pre-existing skin disease (e.g. atopic eczema)
• It is often associated with occupations that may be handling irritating materials, such as hairdressers, health care staff, builders, and cleaners
• Common irritants are detergents and bleach
  • Other examples include water, nappy rash (urine - flexures will be spared), 'lip-lick' chelitis

Clinical features

• There may be burning, pain, and stinging
• Eczematous rash appears localised to the direct area of contact
• The hand is the site that is commonly affected
• May be difficult to distinguish from allergic contact dermatitis (and may be overlap/co-exist)

Investigations

• Clinical diagnosis, attempt to identify triggers from history
• If trigger can’t be identified, patch testing may be required

Management

• Avoidance of trigger
• Symptomatic management includes topical hydrocortisone and emollients