Allergic contact dermatitis (ACD) is a T cell-mediated delayed hypersensitivity reaction (Gell and Coombs Type IV). It is caused primarily by fragrances and preservatives; and less commonly by emulsifiers found in hand-hygiene products.22,23 Iodophors may cause ACD, but ACD with alcohol-based products is uncommon.19,23,24 ACD usually begins as a rash, redness, and itching that may progress to oozing skin blisters and may spread to areas of skin untouched by the product.
