CAUSES AND SYMPTOMS OF CONTACT DERMATITIS IN ADULTS
Causes and pathogenesis
The main cause of the disease most often remains unexplained. It is believed that an important role is played by the pathologies of the immune system, an excessive response to stimuli that are harmless to a healthy person (the mechanism by which allergies develop). But an increase in the level of histamine in patients is not always noted, therefore, it would be inaccurate to assert that contact dermatitis is a type of allergy.
In addition, contact dermatitis in adults can occur in the background of complete health. So, for example, occurs when the skin comes into contact with any caustic substance, most often such a reaction is noted on detergents for deep cleaning. Such substances require compliance with safety measures (work in gloves).
We should also mention professional dermatitis. It is a type of disease that occurs when working with industrial substances (chemical, pharmaceutical industry). As a rule, if a patient complies with safety regulations when working with industrial caustic substances, the disease rarely develops, but it is not always possible to completely avoid skin contact with similar compounds.
What substances cause contact dermatitis?
Any substance that gets on the skin and causes its unhealthy reaction can be a provoking factor for the disease. That is why the disease refers to unspecified dermatitis. Most often it turns out to be:
- Household chemicals.
- Detergents for household appliances and cars.
- Paints and varnishes.
- Cosmetics and skin care products.
- Food products, especially seasonings.
- Toxic chemicals.
- Vegetable toxins and insect venom.
This is not a complete list of substances that cause contact dermatitis. Professional stimuli are considered a separate group of substances, and not all experts agree whether professional dermatitis should be considered as a kind of contact dermatitis.
Signs of disease
Contact dermatitis (usually on the hands, but it happens on other parts of the body) appears almost immediately after contact with an irritating substance. Delayed forms of hypersensitivity practically do not occur and always have an allergic component in their pathogenesis. The most characteristic signs are itching and redness of the skin.
The mild course of contact dermatitis is manifested only by redness and itching, in the more severe case, bubbles may appear, which tend to merge and spread. The affected area may be limited to the area of contact with an irritating substance or expand beyond it.
In severe cases, contact dermatitis becomes exfoliative: large fragments of skin are exfoliated at the site of the blisters. Intensive combing of the affected area does not alleviate the condition, but only provokes bubble ruptures and promotes infection.
Severe contact dermatitis in adults is accompanied by general symptoms: malaise, headaches, flu-like symptoms, fatigue and general weakness. Mental and physical performance weakens, body temperature may rise.
Do children have it?
In children, this disease is relatively rare. Its conditional precursor is pediatric dermatitis of unspecified etiology. This disease can occur in infants for a variety of reasons, from hereditary pathologies to improperly prepared mixture. In such cases, the doctor recommends completely eliminating all sorts of allergens and irritants, and again include them in the baby’s life gradually, so that his immune system can get used to them and form the correct reaction.
At an older age (school and adolescent) manifestations of contact dermatitis are similar to adults. The main difference is that in a small patient, severe forms develop much more often if the disease is run on gravity. There are frequent cases of dermatitis during puberty when hormonal changes occur in the body. The appearance of allergic manifestations is possible at this time.
Acute and Chronic Disease
Acute contact dermatitis on the hands is a frequent reaction to caustic and irritating substances, for example, detergents for certain types of surfaces, solvents and paints, and others. Also, a similar reaction can occur on relatively safe substances (dish detergent, cosmetics) and stop almost immediately after contact. This course is considered acute. An acute reaction is characteristic of insect bites and exposure to plant toxins (nettle).
Chronic contact dermatitis occurs every time after contact with an irritant. Over time, the full list of prohibited substances becomes very wide, which greatly complicates the treatment.
Knowledge of the symptoms and methods of treatment for contact dermatitis help make life easier for patients. If you do not take action in a timely manner, complications of the disease may develop. Most often they are associated with the penetration of the infection into the skin, less often with the deterioration of the general condition.
Bacteria penetrate the affected area in cases of non-compliance with the rules of personal hygiene. In such cases, the symptoms of contact dermatitis are joined by a local temperature rise, swelling, and the appearance of bubbles with purulent contents. Body temperature may rise, signs of infectious disease occur.
Common condition disorders occur with a large lesion area. In this case, the heat transfer is disturbed, the transport of a number of substances deteriorates, the work of sweat and sebaceous glands, the development of more serious skin pathologies is possible. A violation of the lymph flow, a change in sensitivity, rough scars, excessive or insufficient sweating can be observed as well.
The long duration of contact dermatitis can stimulate the activity of the immune system, which leads to the development of allergic or autoimmune diseases. There is no unambiguous connection between these phenomena, but indirect evidence confirms that patients with contact dermatitis have a higher risk of similar diseases than other people.
Can the dermatitis of unspecified etiology lead to a threat to the patient’s life? This happens quite rarely, as a rule, it is possible to take timely therapeutic measures. However, if the patient does not seek medical attention, complications can become dangerous. Special attention is deserved to:
- Symptoms of contact dermatitis in children younger than a year, pregnant women who have not previously suffered from such a pathology.
- Formation of large weals and active skin exfoliation.
- The appearance of pus in the affected areas.
- The sharp deterioration of the general condition on the background of contact dermatitis.
- The merger of bubbles with purulent contents into large blisters, the release of pus from the erosions that remain after them.
- Exacerbations of contact dermatitis for no apparent reason more than once every six months.
If a patient has noticed such signs in himself or his child, he should consult a doctor as soon as possible. The delay can cost the patient life and health. As a rule, such a course is not characteristic of contact dermatitis, but for more severe forms of skin diseases, like exfoliative or necrotic dermatitis, Lyell’s syndrome.
Diagnosis and treatment
To cure contact dermatitis on the hands, an integrated approach is required. The diagnosis is usually made clinically i.e. by the presence of characteristic complaints and external signs. A patient survey reveals a connection between contacts with irritants and signs of pathology.
The doctor may prescribe a number of tests, for example, a general and biochemical blood test, bacteriological seeding from the wound and others to determine how much the disease has affected the general condition of the body and whether the inflammatory process on the skin is a manifestation of more serious pathologies.
The patient’s lifestyle is the first thing that will affect the treatment of contact dermatitis in adults and children. Potential stimuli are detected by the method of special tests. In laboratory conditions, the patient’s skin is exposed to small amounts of possible stimuli, and if a negative reaction occurs, the substance falls into the forbidden list.
In addition to excluding contact with identified irritants, a number of restrictions will be required. In particular, it is necessary to ensure a hypoallergenic life. The bans, in this case, are not as categorical as in allergic dermatitis, but it is desirable for the patient:
- Use household chemicals, detergents, paints and solvents only in gloves.
- Use only specially selected hypoallergenic cosmetics and hygiene products for body care.
- Limit contact with plants and animals.
- Doing wet cleaning at home regularly.
- Use repellent to prevent insect bites.
Treatment of contact dermatitis in the period of exacerbation requires the use of medical agents. This can be local remedies (creams and ointments), and common for the reception inside. For local treatment, creams that reduce itching (Celestoderm), antiseptics (Miramistin, Chlorhexidine), creams that accelerate the recovery of the skin (Bepanthen) are used. The use of drugs with a drying effect is not recommended, they only worsen the skin condition.
It is recommended to use not only local means but also drugs for oral administration for people working with professional irritants. Antihistamines, anti-inflammatory drugs of hormonal and non-hormonal origin are prescribed to relieve itching. The treatment regimen is selected individually.
Complications of contact dermatitis are treated in the hospital with the use of antibiotics. If necessary, intravenous saline and glucose solutions are administered. In some cases, such a disease can cause disability, if there are a severe course and frequent exacerbations with a high risk of complications.
Contact dermatitis is a fairly common disease. Avoiding its symptoms is very difficult, and there are no effective primary prevention methods. However, this disease can be treated, and if you start this process on time, it is possible to maintain the patient’s previous quality of life.