Description

• Contact Dermatitis is an inflammatory skin reaction involving the epidermis and dermis that is caused by exposure to allergenic or irritating substances in the environment. The acute form is characterized by erythema, oedema, vesiculation, and pruritus, while the chronic form may exhibit xerosis, lichenification, and hyperkeratosis
• It is sometimes referred to as "Occupational Dermatitis," as it is very common in occupations where individuals come into frequent contact with irritants and allergens.

Types

• Contact dermatitis may involve a reaction to a substance that the person gets exposed to, or use repeatedly. Although there may be no initial reaction, regular use (for eg- nail polish remover, preservatives in contact lens solutions, or repeated contact with metals in earring posts and the metal backs of watches) can eventually cause sensitivity and reaction to the product
• Contact dermatitis can be classified into four based on Aetiology 1. Irritant contact dermatitis (ICD) -Non immunological Allergic contact dermatitis (ACD) -Complex immune 3. Photo contact dermatitis (PCD) -Chemical, Require light induced UV Spectrum to cause Skin Response 4. Systemic contact dermatitis
• ICD is inflammation of the skin typically manifested by erythema, mild oedema, and scaling. Irritant contact dermatitis is the clinical result of sufficient inflammation arising from the release of proinflammatory cytokines from skin cells (principally keratinocytes), usually in response to chemical stimuli. Acute Irritant Dermatitis is characterized by vesicles and bullae. Chronic Irritant dermatitis manifests as hyperkeratosis, fissuring and scaling
• Allergic contact dermatitis (ACD) is a delayed type of induced sensitivity (allergy) resulting from cutaneous contact with a specific allergen to which the patient has developed a specific sensitivity. This allergic reaction causes inflammation of the skin manifested by varying degrees of erythema, oedema, and vesiculation
• Systemic contact dermatitis Patients who have been sensitized to topical allergens may develop generalized eczematous inflammation if these allergens or chemically related substances are ingested. Ordinarily allergic eczematous CD is produced by external exposure of the skin to an allergen. Occasionally, systemic administration of contact allergens or immunochemically related substances may produce a generalized eczematous eruption in a sensitized individual. Such an eruption is referred to as Systemic Contact Dermatitis
• Photo contact dermatitis is photo sensitivity induced by chemicals can be caused by exogenous or endogenous agents. Exogenous photo sensitizers can be categorised into those administered systematically and those applied topically. Photosensitivity induced by exogenous agents can be divided into photo toxicity and photo allergy. Photo toxicity is the result of direct tissue injury caused by the photo toxic agent and radiation. In contrast photo allergy is a Type IV delayed hypersensitivity response. It has a sensitization phase, occurs only in sensitized individuals, and requires only a minimal concentration of the photo allergen

Differential Diagnosis

• Erysipelas: Non pruritic , rapidly spreading , well defined
• Atopic Dermatitis
• Seborrhoeic dermatitis

Investigation

• Usually clinical diagnosis is made
• Patch test is diagnostic and helps to identify allergens involved

Treatments

• Avoid contact of the etiological factor

Internal medicines

• Padolakaturohinyadi kashaya- reduce oozing
• Gudoochyadi kashaya
• Aragwadhadi kashaya
• Chandraprabha gutika
• Guggulu panchapala choorna with Madhu
• Kaisoraguggulu gutika
• Doosheevishari gutika
• Sudarsanam gutika – if pain is present

Procedures

• Triphala /Guduchyadi kashaya kshalana
• Rasottamadi lepa
• Tiktaka ghrita – ext application
• Dineseladi / Neeli tailam / Sudhadoorvadi keram- ext application

Department

Agada Tantra