Irritant contact dermatitis - Anogenital in
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Synopsis
Contact dermatitis of the penis is more often of the irritant type rather than allergic due to the persistent moisture and maceration in the genital region. Most males are susceptible to irritant dermatitis.
Soaps, detergents, antiseptic solutions, and topical medications are often the source of irritation. Prolonged or recurrent exposure to an irritant often causes the skin to become lichenified, hyperkeratotic, and inflamed.
Early in the course of irritant contact dermatitis, patients typically present complaining of a burning or stinging; the symptoms and skin eruption usually follow the exposure by hours if the irritant is strong (whereas in allergic contact dermatitis, symptoms are usually delayed by approximately 2 days following exposure). As the irritation becomes chronic and the skin continually inflamed, pruritus can become a predominant symptom.
Codes
ICD10CM:L24.9 – Irritant contact dermatitis, unspecified cause
SNOMEDCT:
110979008 – Primary irritant dermatitis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Irritant contact dermatitis can often be misdiagnosed for allergic contact dermatitis (allergic CD) or contact urticaria. The reaction with contact urticaria will occur in minutes to hours whereas the contact dermatitis takes 24-48 hours. Allergic CD tends to have a more vigorous response than irritant CD does. Patients often have blisters, exudate, edema, and erythema with an allergic reaction. With an irritation reaction, usually only erythema, edema, and a raw, burning sensation are present.
- Atopic dermatitis
- Impetigo
- Genital herpes simplex
- Cellulitis
- Balanoposthitis
- Psoriasis
- Lichen planus
- Reactive arthritis
- Lichen simplex chronicus
- Bowenoid papulosis
- Bowen disease
- Extramammary Paget disease
- Kaposi sarcoma
- Tinea cruris
- 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.Subscription Required
References
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Last Reviewed:08/13/2017
Last Updated:08/15/2017
Last Updated:08/15/2017
Patient Information for Irritant contact dermatitis - Anogenital in
Overview
Irritant contact dermatitis is an inflammatory rash caused by direct chemical injury to the skin. Unlike allergic contact dermatitis, which appears 48-72 hours after exposure to an allergen, the symptoms of irritant contact dermatitis can result within a few hours if the exposure is a strong irritant.- Patients typically present complaining of a burning or stinging early in the course of irritant contact dermatitis.
- As the irritation becomes chronic and the skin becomes continually inflamed, itching can become a predominant symptom.
Who’s At Risk
Irritant contact dermatitis can occur at any age.- Patients with a history of eczema (atopic dermatitis) are particularly predisposed.
- Environmental factors include frequent hand washing and repeated exposure to water, solvents, fiberglass, mild acids, and alkalis.
- Dry air can predispose to irritant contact dermatitis.
Signs & Symptoms
The most common location for irritant contact dermatitis is the hands, though any body surface can be involved, including the genitals.- Lesions can appear pink to red.
- In chronic cases, affected areas may develop scale and cracks.
- In acute cases, areas may have a sharp border corresponding to the areas of chemical exposure.
- On the fingertips, peeling of the skin, cracks, and scaling may be noted.
Self-Care Guidelines
- Remove the offending exposure and protect the skin from re-exposure.
- For irritated skin in body folds, consider a barrier cream with zinc oxide paste, such as Desitin.
When to Seek Medical Care
Seek medical evaluation for a rash that does not resolve with self-care measures.Treatments
- Your physician may recommend that you use petroleum jelly or a thick moisturizing cream applied directly to wet skin after bathing. Apply frequently (at least twice daily) to moisturize and protect the skin.
- Mild- to mid-potency topical steroids may be prescribed if inflammation is pronounced.
References
Bolognia, Jean L., ed. Dermatology, pp.227, 241-249. New York: Mosby, 2003.
Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed, pp.1309-1314, 2370. New York: McGraw-Hill, 2003.
Irritant contact dermatitis - Anogenital in
See also in: Overview,External and Internal Eye