A 31-year-old man who has worked for several years installing fiberglass insulation has developed itchy, irritating lesions on his wrists and forearms over the last several months
He has applied moisturizing creams repeatedly and has taken antihistamines but has experienced no significant improvement. He is understandably concerned about the potential effect this could have on his livelihood and has asked his care provider when treatment will resolve the problem. What is the care provider's most appropriate response?
A)
"A steroid cream will likely help but often the skin problem lasts long after contact with the product that irritates the skin."
B)
"You're clearly allergic to the fiberglass in your insulation, and over-the-counter allergy medications are likely to resolve the problem quite rapidly."
C)
"The problem is that your skin is producing and sloughing off cells prematurely; this will respond well to a topical steroid."
D)
"There are medications I can prescribe that will cure this sensitivity, but they tend to take many months to take full effect."
Ans:
A
Feedback:
Topical corticosteroids are often used in the treatment of irritant contact dermatitis, but symptoms can persist long after contact with the irritant ceases. The course of the man's complaint is suggestive of irritant, not allergic, contact dermatitis. Hyperkeratinization is characteristic of psoriasis, and a sensitivity can be treated but not cured.
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