ABSTRACT
Irritant contact dermatitis is the hallmark of an irritant reaction. It has been
traditionally classified into an acute and chronic type. Strong irritants will induce
a clinical reaction in a single application, whereas with less potent irritants the
response may be delayed and subclinical, requiring repeated or prolonged
application (Hassing et al., 1982: 164). However, not all irritant reactions manifest
as dermatitis. Water, being an unconventional irritant, may irritate the skin in
a way other than dermatitis. Fingertip dermatitis, or wear and tear dermatitis,
is the best example of cumulative irritant reaction. In this condition, hands are
chronically irritated by a variety of insults, especially water. The involved skin
is hardened and fissured, but typical signs of dermatitis or inflammation such
as erythema, swelling or scaling are often lacking in the early stage. People who
deal with wet work, such as hair dressers, hospital cleaners, cannery workers,
bartenders are especially at risk (Hassing, 1990: 22). In rare conditions, water
may also produce pruritus (Potasman, 1990: 26), urticaria (Medeiros, 1996: 6)
or pain (Shelley and Shelley, 1998) in susceptible patients.
