​Dermatology - Allergic Contact Dermatitis

​Dermatology - Allergic Contact Dermatitis 
(ACD) stands for allergic contact dermatitis.
The eczematous (papules, vesicles) systemic condition known as atopic dermatitis (ACD) is characterized by hapten-specific T cell–mediated inflammation that occurs after an individual comes into touch with a substance to which they have been sensitized. Sensitization can take place anywhere from weeks to months or even years following exposure. Sensitized T cells are responsible for targeting the allergen irrespective of where it may come into touch with the skin. This results in the hypersensitivity of the entire skin to the allergen.


It takes at least two days after contact for the eruption to begin. Multiple exposures will eventually result in a crescendo reaction.
It is possible to have intense pruritus, stinging, and discomfort. Frequent fever is a possible symptom of severe responses.

Within a short period of time, well-defined, erythematous, and edematous lesions manifest themselves, accompanied by superimposed papules that are tightly spaced apart and nonumbilicated vesicles. Both bullae and confluent erosions, as well as crusts, could be present. Plaques of moderate erythema are found in subacute cases, and they are characterized by small, dry scales. Additionally, smaller, red, pointed or spherical, erythematous, hard papules and scales may also be present. The presence of satellite, small, hard, rounded or flat-topped papules, excoriations, and pigmentation are characteristics of lichenified plaques that are found in chronic individuals. In the beginning, lesions are confined to areas of contact and are frequently linear, with artificial patterns (also known as "outside job" for short). Eventually, the lesions might spread.

A history and a clinical examination are used to make a diagnosis. Both histopathology and the verification of the allergen through a patch test could be beneficial in this situation. Erysipelas, irritating contact dermatitis, atopic dermatitis, seborrheic dermatitis (face), psoriasis (palms and soles), epidermal dermatophytosis (KOH), fixed drug eruption, and phytophotodermatitis are all conditions that should be excluded.


The allergen should be identified and removed, and patients should be given advice on how to avoid further exposure. Do not remove the caps of bigger vesicles; instead, drain them. Apply wet dressings by using cloths that have been soaked in Burow's solution and to change them every two to three hours. Glucocorticoid ointments and gels (classes I–III) should be applied topically, and adequate skin lubricants should be used.