Dermatitis
COMMON TYPES
- CONTACT DERMATITIS
- ATOPIC ECZEMA
- DRUG ALLERGY
- FOOD ALLERGY
- SERUM SICKNESS
- URTICARIA (See Separate chapter)
- ALLERGIC RHINITIS (See Separate Chapter)
- ALLERGIC ASTHMA (See Chapter on ‘Bronchial Asthma’)
General Points
An allergic basis is more likely, if
a) the onset is from childhood,
b) there is positive family history,
c) various features occur together as asthma plus rhinitis, or rhinitis plus eczema, and
d) there is influence of seasons, geographic location etc.
lm unotherapy performed by a specialist leading to gradual desensitisation takes about 6 to produce results The patient has to be told this clearly.
CONTACT DERMATITIS
- Clinical diagnosis can be made by careful history and physical examination. Usually 24-48 hours elapse before the dermal lesions manifest Vesicular and streaky in acute lesions. In chronic contact dermatitis, they could be crusting. When acquired at work, the lesions are on the dorsum of hands as palms are usually spared.
- The usual causes are “Bindi’ dermatitis, lipstick allergy, alergy to artificial jewellery, plastic slippers, tooth paste, synthetic fibres in undergarments, watch straps, perfumes toothpaste rubber products, preservatives in topical medications, topical antibiotics hair dyes “Patch test” read after 48 hours helps make rm diagnosis. wet cement, metal covered objects, insecticide
MANAGEMENT
Avoidance measures as and when the cause is known.
Antihistamines as and when required.
Local corticosteroids like flucinolone or clobetasol on the affected areas. If the face is involved better to use Mometasone, as it does not cause acne.
Systemic steroids, if absolutely necessary.
Immunotherapy does not help.
