DERMATITIS

Dian Natasya Oktober 2016

Definisi
Dermatitis: berbagai kondisi
dermatologik yang umumnya
ditandai dengan kemerahan
(erythema)
Dermatitis ~ eczema

Handbook of Nonprescription Drugs

Symptoms in The Pharmacy
 Contact dermatitis is skin inflammation caused by irritants
or allergic sensitizers
Allergic contact dermatitis, an antigenic substance triggers
an immunologic responses produce the allergic skin reaction,
sometimes several days later.
Irritant contact dermatitis is caused by an organic
substance that usually results in a reaction within a few hours
of exposure.
Atopic dermatitis is an inflammatory condition with genetic,
environmental, and immunologic mechanisms.
Neuropeptides, irritation, or pruritus-induced scratching may
cause release of proinflammatory cytokines from
keratinocytes.
Pharmacotherapy Handbook, 9th edition
Irritant contact dermatitis
Chemicals or physical agents damage
the surface of the skin faster than the
skin is able to repair the damage.
Irritants remove oils and moisture
(natural moisturising factor) from its
outer layer, allowing chemical
irritants to penetrate more deeply and
cause further damage by
triggering inflammation
The main irritants
water, detergents, solvents, acids,
alkalis, adhesives, metalworking
fluids and friction

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Allergic contact dermatitis
caused by a type IV, T cellmediated,
delayed hypersensitivity reaction in which
a foreign substance comes into contact
with the skin and is linked to skin protein,
forming an antigen complex that leads to
sensitization. Upon reexposure of the
epidermis to the antigen, the sensitized T
cells initiate an inflammatory cascade,
causing the skin changes associated with
allergic contact dermatitis.
The allergen
common allergies are to nickel
(jewellery), fragrances, preservatives,
rubber (gloves), dye
(hair colourants),adhesives of various
kinds, and topical medications such
as antibiotics
Ale, S.Iris, Maibach, Howard I. 2006. Irritant Contact Dermatitis versus Allergic Contact Dermatitis. Springer Berlin Heidelberg
Atopic Dermatitis

erythema, edema, xerosis, erosions/excoriations,

oozing and crusting, and lichenification, vary by patient
age and chronicity of lesions.
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Drug induced skin reactions
Drug-induced hyperpigmentation may be related to
increased melanin (eg, hydantoins), direct deposition
(eg, silver, mercury, tetracyclines, and antimalarials),
or other mechanisms (eg, fluorouracil).
Drug-induced photosensitivity reactions may be
phototoxic (a nonimmunologic reaction) or
photoallergic (an immunologic reaction)
Phototoxicity: amiodarone, tetracyclines,
sulfonamides, psoralens, and coal tar.
Photoallergic: sulfonamides, sulfonylureas, thiazides,
nonsteroidal antiinflammatory drugs (NSAIDs),
chloroquine, and carbamazepine.
 Treatment goals
Relieve symptoms (inflammation, dermal tenderness,
irritation)
ICD Prevent continued exposure
Educate the patients

Protect the area affected during the acute phase of rash

Prevent itching and excessive scratching
ACD Prevent the acumulation of debris

Stop the itch-scratch cycle

Maintain skin hydration
AD Minimize trigger factor
Prevent secondary infection
Interventions
Moisturizers
Bathing
Limited use of nonsoap cleansers (neutral to low
pH, hypoallergenic, and fragrance free)
Cool compresses
Calamine lotion
Topical corticosteroid
Topical calcineurin inhibitor
Topical antimicrobial/ antiseptics
Sedative antihistamines
Interventions
SELF CARE OF DERMATITIS
C:\Users\ASUS\Desktop\FARKOM 1 2016\Self care of Dermatitis.doc

Handbook of Non Prescription Drugs. 16th edition

Guidelines of care for the management of atopic
dermatitis, American Academy of Dermatology
2014
Guidelines for the management of contact
dermatitis: an update, British Journal of
Dermatology 2009
References
Young L. 2009. Handbook of Non Prescription Drugs. 16th
edition. American Pharmacist Association: Washington DC
DiPiro JT. 2015. Pharmacotherapy Handbook. 9TH edition.
Mc Graw Hill Education: USA
Nathan A. 2008. Managing Symptom in the Pharmacy.
Pharmaceutical Press: London
Usatine RP. Contact dermatitis. In: Usatine RP, Smith M,
Mayeaux EJ Jr, et al., eds. Color Atlas of Family Medicine.
New York, NY: McGraw-Hill; 2009.
Usatine R. 2010. Diagnosis and Management of Contact
Dermatitis. Am Fam Physician. 2010 Aug 1;82(3):249-255.
Guidelines of care for the management of atopic dermatitis,
American Academy of Dermatology 2014
Guidelines for the management of contact dermatitis: an
update, British Journal of Dermatology 2009