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Contact Dermatitis Trends and Strategies

  • Always keep scabies in your differential diagnosis when seeing a patient with a question of allergic contact dermatitis, especially involving the finger web spaces.

  • Consider use testing for suspected ACD-place a few small drops of potential substances (daily use item) and cover with a bandage. Differentiate irritation vs contact (True allergen will worsen over 24-48 hours after removal, whereas irritant will get better quickly (decrescendo effect).

  • Disperse blue allergy typically involves sites that are in close contact with clothing (thighs or in the axilla, sparing the vault) and is worsened by friction and sweating. Conversely, intertrigo/yeast will involve the axillary vault.