This summary discusses adult patients. Allergic contact dermatitis in children is addressed separately.
Contact dermatitis presents as either allergic or irritant in etiology. While irritant contact dermatitis represents the direct toxic effect of an offending agent on the skin, allergic contact dermatitis (ACD) represents a delayed-type (type IV) hypersensitivity reaction that occurs when allergens activate antigen-specific T cells in a sensitized individual. Consequently, whereas irritant contact dermatitis can occur after one exposure to the offending agent, ACD typically requires repeat exposures before an allergic response is noted. ACD can occur 24-48 hours after exposure to the offending agent.
ACD can occur in response to topical agents, systemic exposure via ingestion, or innocuous transfer of the culprit agent via the fingertips.
Use of soap, topical anesthetic agents, spermicides, rubber accelerators found in condoms, and topical steroids have all been reported to cause ACD in the genital area. Lipstick-induced penile dermatitis has not been reported but is noted as a theoretical concern for men sensitive to octyl gallate.
Passive transfer of poison ivy resin has been implicated in penile ACD.
Allergic contact dermatitis - Anogenital in
See also in: Overview,Cellulitis DDx,External and Internal Eye,Hair and Scalp,Nail and Distal Digit,Oral Mucosal LesionAlerts and Notices
Important News & Links
Synopsis
Codes
ICD10CM:
L23.9 – Allergic contact dermatitis, unspecified cause
SNOMEDCT:
40275004 – Contact dermatitis
L23.9 – Allergic contact dermatitis, unspecified cause
SNOMEDCT:
40275004 – Contact dermatitis
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Cellulitis – Plaque margins in cellulitis are often less distinct than those of contact dermatitis. The plaques of contact dermatitis are sharply demarcated and frequently take on bizarre geometric shapes and patterns.
- Erysipelas
- Angioedema
- Psoriasis
- Lichen simplex chronicus
- Contact urticaria
- Herpes virus infection
- Seborrheic dermatitis
- Impetigo
- Tinea cruris
- Intertrigo
- Scabies
- Fixed drug eruption
- Red scrotum syndrome
- Zoster
- Balanoposthitis
- Zoon balanitis
- Lichen planus
- Reactive arthritis (Reiter syndrome)
- Extramammary Paget disease
- Candidiasis
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:10/02/2017
Last Updated:02/13/2018
Last Updated:02/13/2018
Patient Information for Allergic contact dermatitis - Anogenital in
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Allergic contact dermatitis - Anogenital in
See also in: Overview,Cellulitis DDx,External and Internal Eye,Hair and Scalp,Nail and Distal Digit,Oral Mucosal Lesion