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How Does Contact Dermatitis Affect Quality of Life?

Contact dermatitis is a painful skin rash that can appear anywhere on the body. It affects 1 in 5 people. Anyone can get contact dermatitis. The itchiness can greatly impact a patient’s quality of life, so prompt medical attention may be needed depending on the severity of the rash.


What is contact dermatitis?

A person may develop contact dermatitis after coming into contact with an allergen. The itchy, red rash appears wherever the allergen touches the skin. It’s important to remember that the rash isn’t contagious.


Just like any skin condition, it can increase in severity if left untreated. It becomes really uncomfortable. With a lot of cosmetic and pharmaceutical products on the market, contact dermatitis could be triggered just by the fragrances in a perfume, detergents, metals, and plants.

Fragrances followed by preservatives and hair dyes are known to be the most common causes of contact dermatitis.[2]


Symptoms


Some symptoms of contact dermatitis include:

  • Swollen hive-like rash in patches localized or spreading

  • Itchiness and burning sensation

  • Blisters

  • Scaly skin

  • Painful when severe


How is contact dermatitis diagnosed?


Just like with any other skin condition, there are a few steps that need to be considered when it comes to diagnosing contact dermatitis. Often patients arrive frustrated to the doctor because they have tried ineffective home treatments. They may have higher expectations during their visits. Don’t lose hope.

To a confirmed diagnosis :

  • Clinical evaluation by a family physician: usually they will start off with a treatment and refer you to a dermatologist

  • Physical exam by a dermatologist: They will perform a physical examination, ask questions and give you a treatment.

  • Patch test: When the rash is recurring and an allergen may be involved, the dermatologist may recommend a patch test. The patch test is a test where common allergens are placed on the back of the individual to identify a reaction.

Usually, within a week, a reaction develops and a specific substance can be identified.

  • Biopsy: in some cases, a biopsy ( tissue sample ) is taken to confirm that the rash is contact dermatitis.


How is quality of life affected?

Working in a health care setting, most patients with contact dermatitis are desperate to find a solution to their rash. It has a great impact on their quality of life and work environment.

Based on a study with 150 acute contact dermatitis (ACD ) patients, 59.3% reported a moderate effect on their quality of life. [3]


Often people experience :

  • Difficulty sleeping due to itching

  • Psychosocial consequences [3]

  • Difficulty performing their job or need to change career: most individuals are involved in constructruction, health care and textile industries.[3]


Management of contact dermatitis


Topical or oral Corticosteroid and antihistamine


The first line of treatment for contact dermatitis is topical ( clobetasol 0.05% or triamcinolone 0.1%) or oral corticosteroid ( Prednisone). It depends on the severity of the rash and the size of the area affected. The purpose of the treatment is to help soothe the rash. Antihistamine such as ( Blexten, Benadryl, Cetirizine ) is also prescribed in combination to help the itchiness and swelling. If the ACD happens on a delicate area, such as skin folds or eyelids, topical calcineurin inhibitors of PDE4 inhibitors may also be effective. [4]

Ointment-based moisturizers are recommended to hydrate and regenerate the skin. [4]


Prevention of the allergen or irritant


When contact dermatitis is caused by an allergen or irritant, avoid that

particular substance.


Remove all products or materials in the house that can contain that substance to prevent the rash's recurrence.


If it's a substance at work, discuss it with your manager or boss and explain the situation and see if there is a solution to avoid the product, change departments, or tasks.


Reassurance and support for the client’s quality of life

Since contact dermatitis can take weeks to months to be entirely resolved, it is important that the patients have the necessary resources and support from healthcare professionals.


Having access to a multidisciplinary team ( Pharmacist, Nurses, Therapist, Dermatologist ) that follows up on the patients would help them cope much better with the condition.


Patient education about contact dermatitis, side effects of medication, and safe products should be given and monitored. Parents with children that are affected by contact dermatitis must be provided with counseling and support as well.


Conclusion

Contact dermatitis is a common dermatological condition that can impact individuals' quality of life and their occupational activity. It can take weeks to a few months to heal.


An interprofessional healthcare approach is essential for individuals and families to cope with the situation.


References:


1.Adler BL, DeLeo VA. Allergic Contact Dermatitis. JAMA Dermatol. 2021;157(3):364. doi:10.1001/jamadermatol.2020.5639

https://jamanetwork.com/journals/jamadermatology/fullarticle/2775575#:~:text=Allergic%20contact%20dermatitis%20is%20common,to%201%20in%205%20people.



2. González-Muñoz, P., Conde-Salazar, L., & Vañó-Galván, S. (2014). Allergic contact dermatitis caused by cosmetic products. Actas dermo-sifiliograficas, 105(9), 822–832. https://doi.org/10.1016/j.ad.2013.12.018 https://www.actasdermo.org/es-allergic-contact-dermatitis-caused-by-articulo-S1578219014002455


3. Kalboussi, H., Kacem, I., Aroui, H., El Maalel, O., Maoua, M., Brahem, A., El Guedri, S., Chatti, S., Ghariani, N., & Mrizak, N. (2019). Impact of Allergic Contact Dermatitis on the Quality of Life and Work Productivity. Dermatology research and practice, 2019, 3797536. https://doi.org/10.1155/2019/3797536

https://www.hindawi.com/journals/drp/2019/3797536/


4. Murphy PB, Atwater AR, Mueller M. Allergic Contact Dermatitis. [Updated 2022 Sep 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532866/


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