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BHUIYAN, Ma YOUSUF
MBBS. MSc ( Sweden)
Physician, dermatology
Difference between allergic and irritant contact dermatitis may pose considerable problem in clinical
practice since both inflammatory disease have clinical, histological and immunohistological similarities,
which have been cited in this table.
Contributing factor The risk of developing irritant contact Contributing factors include allergen
dermatitis is particularly high in concentration, duration of exposure,
individuals with atopic dermatitis. and presence of other skin diseases.
Investigation There are no specific tests that can Patch tests are used to confirm allergic
reliably show what the effect of an contact dermatitis and identify the
irritant will be in each individual case. allergen(s).
B. Similarities between irritant and allergic contact dermatitis:
Allergic contact dermatitis may look similar to irritant contact dermatitis, but it is caused by an
immune response following skin contact with an allergenic substance. Tiny quantities may be
sufficient to cause allergy, whereas a certain minimum exposure is necessary for irritant contact
dermatitis. Irritant and allergic contact dermatitis may coexist.
1. The morphologic changes, time course to the development of dermatitis, and histological
changes have long been known to overlap for both allergic and irritant contact dermatitis
reactions. Studies of the behavior of Langerhans cells, cytokines, and adhesion
molecules have found more similarities than differences between irritant and allergic
reactions. At present, the difference between irritants and allergens is more conceptual
than demonstrable.
2. The epidermal and dermal cell activity that produces the cascade of inflammation
appears to be similar in both cases.
3. Most cases of contact dermatitis have a similar appearance regardless of the mechanism
or cause of inflammation. Inflammatory responses can be categorized into acute, sub
acute, and chronic phases. In all phases, a key feature is localization to the area of
contact all most similar.
4. The affected skin may be red, swollen and blistered or dry and bumpy in case of allergic
contact dermatitis, which is a similar skin condition is caused by excessive contact with
irritants. Irritants include water, soaps, detergents, solvents, acids, alkalis, and friction.
5. In case of irritant contact dermatitis, accidental exposure to a strong irritant such as a
strong acid or alkali substance may cause an immediate skin reaction resulting in pain,
swelling and blistering which symptoms also found in case of acute allergic contact
dermatitis.
6. Contact with mild irritants such as water and soap or detergent may over a period of
weeks cause dryness, itching and cracking of the skin. Eventually sores may appear
which form crusts and scales similar to allergic contact dermatitis.