Version May 2024
| Type | History | Clinical manifestation | Prognosis |
| Acute ICD | Acute exposure, usually accidental, to potent irritants (strong acids or alkalis) May develop within minutes after exposure to powerful irritants Nearly all exposed individuals develop skin lesions | Erythema, edema, vesicles, bullae, epidermal necrosis Symptoms – stinging, burning, and pain Decrescendo phenomenon – the healing process begins soon after the removal of the offending substance | Good |
| Delayed acute ICD | Delayed onset (8 to 24 hours after exposure) Some chemicals, such as dithranol (anthralin), podophyllin, epichlorohydrin, propane sulfone, ethylene oxide, and benzalkonium chloride | Similar clinical manifestation to acute ICD Patch testing – highly recommended for differential diagnosis from allergic contact dermatitis | Good |
| Irritant reaction | High-risk groups – wet work workers, such as hairdressers, food preparation workers, bar workers, new mothers, or cleaning personnel | Mild erythema, vesicles or erosions, dryness, chapping, and scaling Usually occur under occlusive areas May evolve to chronic cumulative ICD | Good |
| Chronic cumulative ICD | Most common type of ICD Repeated exposure to weak irritants (soaps, detergents, surfactants, solvents, or oils) High-risk groups – hairdressers, health care personnel, cleaning workers, and metal workers | Erythema and dryness that progress to hyperkeratosis, fissuring, and lichenification Patch testing – highly recommended for differential diagnosis from allergic contact dermatitis | Variable |
| Traumatic ICD | Slower onset after laceration, burn, or acute ICD | Erythema, vesicles or papules, and scaling Prolonged healing time | Variable |
| Acneiform or pustular ICD | Rare, slow onset Tar, oils, naphthalenes, asphalt, chlorinated agents, or grease | Papular or pustular lesions | Good |
| Nonerythematous (suberythematous) irritation | Slow onset Surfactants in soaps, detergents, or cosmetics (cocamidopropyl betaine, coconut diethanolamide) | Subjective discomfort such as stinging, itching, or burning, without visible clinical signs Histologic changes | Variable |
| Sensory (subjective) irritation | Acute onset Mostly in middle-aged women Mainly cosmetic products containing lactic acid or sorbic acid | Lack of clinical signs of inflammation Subjective feeling of stinging, itching, and burning | Excellent |
| Friction irritation | Slow onset Repeated microtrauma and friction from handling wood, plants, coarse paper, or rock wool | Lichenification, hyperkeratosis | Variable |
| Asteatotic irritant dermatitis | Slow onset High-risk group – older adults Mostly in winter | Erythema, dry and cracked skin Intense itching | Variable |
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