Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
ID often appears on the sides of your fingers.ID is not one disease, but rather a result of animmune conditionorallergic reactionthat occurs somewhere else on your body. For example, afungal infectionon your foot activates your immune system, and your immune response triggers ID.
This article will explain how an interface dermatitis reaction happens, the causes and risk factors, and how symptoms are diagnosed and treated.
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from © DermNet New Zealandwww.dermnetnz.org2023.
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from © DermNet New Zealandwww.dermnetnz.org2023.
Anatomy of the Skin
Interface Dermatitis Symptoms
Interface dermatitis (ID) gets its name because it occurs in a specific area of the skin called thedermo-epidermaljunction (in other words, the interface).This sits between the outermost layer of skin, the epidermis, and the middle layer, called the dermis.
Symptoms of interface dermatitis typically involve some or all of the following:
Regardless of where the cause started, the ID response most often occurs on the sides of the fingers. In some cases, it’s on the chest or arms.
Associated itching can often be quite intense.
What Is Erythema?
What Does Interface Dermatitis Look Like?
An ID reaction can vary in appearance from one person to the next because the underlying cause can differ.
This photo contains content that some people may find graphic or disturbing.See PhotoErythema nodosum on the legs.DermNet /CC BY-NC-ND
This photo contains content that some people may find graphic or disturbing.See PhotoErythema multiforme of the hands.DermNet /CC BY-NC-ND
This photo contains content that some people may find graphic or disturbing.See PhotoGuttate psoriasis on the back.DermNet /CC BY-NC-ND
Interface Dermatitis Causes
While certain illnesses or medications can cause a reaction,fungal infectionsare the most common cause. They can include:
However, interface dermatitis can also occur as a result of a bacterial, viral, or parasitic infection, orinsect bites. Tumors have even been associated with ID, often withSweet syndrome.
In some cases, an interface dermatitis reaction may be the first sign of an infection that needs to be treated.
Some people may also develop interface dermatitis as a response to allergiccontact dermatitis, a condition that occurs when your skin comes into contact with an allergen.Contact dermatitis causes an itchy, red rash—sometimes with bumps, blisters, or cracked skin—right where the contact occurred.
Interface dermatitis is also typically seen with:
Several other diseases that are inflammatory, infectious, or cancerous may involve ID changes, as well. While an ID reaction rash cannot be passed from one person to the next, the primary condition that gave rise to the reaction may be contagious in some cases.
What to Know About Lichenoid Dermatitis
Diagnosing Interface Dermatitis
When you have any type of dermatitis, it can be difficult for your healthcare provider to determine which one it is because many types have the same or highly similar symptoms. Many other skin diseases may have a similar presentation, as well.
Skin problems that may appear similar to ID include:
If the underlying cause is evident, your healthcare provider may diagnose ID based on appearance alone. But given the above, testing is often needed.
Research suggests that interface dermatitis is most accurately diagnosed based on the confirmed presence of a condition associated with ID reactions, as well as askin biopsyto confirm the involvement of the dermo-epidermic junction and to rule out certain types of dermatitis.
To determine the underlying condition, if one isn’t obvious, your healthcare provider may perform:
Fungal Culture Test: What to Know
Interface Dermatitis Treatment
How an interface dermatitis reaction is treated depends largely on what caused it in the first place.
ID reactions due to an infection or allergic reaction generally go away when the cause is resolved. Antihistamine creams ororal antihistaminesmay help if an allergic response is suspected or confirmed.
If the cause is a long-lasting illness, such as an autoimmune disease, you may get relief through treatments for that disease or direct treatment of ID symptoms.
Treatments used to reduce ID symptoms themselves include:
In some cases, you may need to cover wounds in order to prevent an infection. Antibiotics may be helpful if an infection occurs. You also may need to discontinue a medication or otherwise avoid a cause related to your ID symptoms.
Creams for the Treatment of Itchy Skin
Possible Future Drug Treatments
A promising new treatment is a biologically produced protein called Serpina3n. In animal studies, it has both prevented and treated ID reactions.More work will need to be done before this treatment can be considered safe and effective in humans.
A newer class of immunosuppressants calledJanus kinase (JAK) inhibitorsis also being looked at as a possible ID treatment.Several JAK inhibitors are already on the market, so if studies remain positive, they may eventually start being prescribed off-label for ID.
How Long It Takes for an ID Reaction to Go AwayHow you stop an ID reaction will depend on the type of lesions and their cause; a chronic illness like cancer and an easily treated drug reaction are very different. As an example, with a lichenoid interface dermatitis linked to oral lichen planus symptoms, treatment can include:Topical corticosteroids for four weeksSystemic corticosteroids (like prednisolone) for three to six weeks before taperingOral retinoids like Soriatane (acitretin) for 24 weeksMethotrexate(often used to treat arthritis) for 24 weeks
How Long It Takes for an ID Reaction to Go Away
How you stop an ID reaction will depend on the type of lesions and their cause; a chronic illness like cancer and an easily treated drug reaction are very different. As an example, with a lichenoid interface dermatitis linked to oral lichen planus symptoms, treatment can include:Topical corticosteroids for four weeksSystemic corticosteroids (like prednisolone) for three to six weeks before taperingOral retinoids like Soriatane (acitretin) for 24 weeksMethotrexate(often used to treat arthritis) for 24 weeks
How you stop an ID reaction will depend on the type of lesions and their cause; a chronic illness like cancer and an easily treated drug reaction are very different. As an example, with a lichenoid interface dermatitis linked to oral lichen planus symptoms, treatment can include:
Summary
Symptoms of interface dermatitis (ID) typically are related to another condition, such as an autoimmune condition or an allergic reaction. In some cases, they can occur due to a serious disease like cancer or follow a stem cell transplant. But they also can be related to medications you take.
Fungal infections are a common cause and among the easiest to treat. Most ID cases resolve with the use of steroid medications, drugs like methotrexate, or newer options like JAK inhibitors. Your healthcare provider may prescribe antibiotics if an infection has complicated your ID symptoms. Prevention may not be possible for some ID causes but talk with your provider about what works.
20 Types of Skin Lesions and What They Look Like
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.El Hasbani G, Kibbi AG, Jawad A, Uthman I.Vacuolar interface dermatitis as a histologic reaction pattern of Sjögren’s syndrome: A case report.Cureus. 2023 Oct 3;15(10):e46412. doi:10.7759/cureus.46412Okiyama N, Yamaguchi Y, Kodera M, Hamaguchi Y, Yokozeki H, Ishiguro N,et al.Distinct histopathologic patterns of finger eruptions in dermatomyositis based on myositis-specific autoantibody profiles.JAMA Dermatol. 2019 Sep 1;155(9):1080-1082. doi:10.1001/jamadermatol.2019.1668Ehlert B, Shegos L, Franklin M, Buckley K, Rodger J.An atypical facial eruption in skin of color: A rare presentation of histiocytoid Sweet syndrome.JAAD Case Rep. 2024 Mar 9;47:6-9. doi:10.1016/j.jdcr.2024.02.027Akahoshi Y, Spyrou N, Hogan WJ, Ayuk F, DeFilipp Z, Weber D,et al.Incidence, clinical presentation, risk factors, outcomes, and biomarkers in de novo late acute GVHD.Blood Adv. 2023 Aug 22;7(16):4479-4491. doi:10.1182/bloodadvances.2023009885Stephan C, Abbas O, Bhawan J.Adnexotropic Variants of the Interface Dermatitides: A Review.Dermatopathology (Basel). 2021 May 21;8(2):135-146. doi: 10.3390/dermatopathology8020020.Journal of the American Academy of Dermatology.An atypical facial eruption in skin of color: A rare presentation of histiocytoid Sweet syndrome.Høgsberg T, Thomsen BM, Serup J.Histopathology and immune histochemistry of red tattoo reactions. Interface dermatitis is the lead pathology, with increase in T-lymphocytes and Langerhans cells suggesting an allergic pathomechanism.Skin Res Technol. 2015;21(4):449–458. doi:10.1111/srt.12213Choi ME, Yang HJ, Lee WJ, Won CH, Chang SE, Choi JH,et al.A case of cutaneous extranodal natural killer/T-cell lymphoma clinically and histopathologically mimicking interface dermatitis.Australas J Dermatol.2020 Nov;61(4):e410-e413. doi:10.1111/ajd.13304Pirrone J, Böer-Auer A.Promyelocytic Differentiation in Infiltrates of Prurigo Pigmentosa: An Analogy to Histiocytoid Sweet Syndrome.Am J Dermatopathol.2020 Feb;42(2):86-91. doi:10.1097/DAD.0000000000001449Oztas M, Ugurlu S, Aydin O.Atorvastatin-induced dermatomyositis.Rheumatol Int. 2017 Jul;37(7):1217-1219. doi:10.1007/s00296-017-3658-9Sussman M, Napodano A, Huang S, Are A, Hsu S, Motaparthi K.Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis.Medicina (Kaunas). 2021 Sep 23;57(10):1004. doi:10.3390/medicina57101004Saito A, Okiyama N, Kubota N, et al.Blockade of Granzyme B remarkably improves mucocutaneous diseases with keratinocyte death in interface dermatitis.J Invest Dermatol. 2018;138(9):2079–2083. doi:10.1016/j.jid.2018.03.1507Wenzel J.Cutaneous lupus erythematosus: new insights into pathogenesis and therapeutic strategies.Nat Rev Rheumatol. 2019;15(9):519–532. doi:10.1038/s41584-019-0272-0Manchanda Y, Rathi SK, Joshi A, Das S.Oral lichen planus: An updated review of etiopathogenesis, clinical presentation, and management.Indian Dermatol Online J. 2023 Dec 22;15(1):8-23. doi:10.4103/idoj.idoj_652_22
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.El Hasbani G, Kibbi AG, Jawad A, Uthman I.Vacuolar interface dermatitis as a histologic reaction pattern of Sjögren’s syndrome: A case report.Cureus. 2023 Oct 3;15(10):e46412. doi:10.7759/cureus.46412Okiyama N, Yamaguchi Y, Kodera M, Hamaguchi Y, Yokozeki H, Ishiguro N,et al.Distinct histopathologic patterns of finger eruptions in dermatomyositis based on myositis-specific autoantibody profiles.JAMA Dermatol. 2019 Sep 1;155(9):1080-1082. doi:10.1001/jamadermatol.2019.1668Ehlert B, Shegos L, Franklin M, Buckley K, Rodger J.An atypical facial eruption in skin of color: A rare presentation of histiocytoid Sweet syndrome.JAAD Case Rep. 2024 Mar 9;47:6-9. doi:10.1016/j.jdcr.2024.02.027Akahoshi Y, Spyrou N, Hogan WJ, Ayuk F, DeFilipp Z, Weber D,et al.Incidence, clinical presentation, risk factors, outcomes, and biomarkers in de novo late acute GVHD.Blood Adv. 2023 Aug 22;7(16):4479-4491. doi:10.1182/bloodadvances.2023009885Stephan C, Abbas O, Bhawan J.Adnexotropic Variants of the Interface Dermatitides: A Review.Dermatopathology (Basel). 2021 May 21;8(2):135-146. doi: 10.3390/dermatopathology8020020.Journal of the American Academy of Dermatology.An atypical facial eruption in skin of color: A rare presentation of histiocytoid Sweet syndrome.Høgsberg T, Thomsen BM, Serup J.Histopathology and immune histochemistry of red tattoo reactions. Interface dermatitis is the lead pathology, with increase in T-lymphocytes and Langerhans cells suggesting an allergic pathomechanism.Skin Res Technol. 2015;21(4):449–458. doi:10.1111/srt.12213Choi ME, Yang HJ, Lee WJ, Won CH, Chang SE, Choi JH,et al.A case of cutaneous extranodal natural killer/T-cell lymphoma clinically and histopathologically mimicking interface dermatitis.Australas J Dermatol.2020 Nov;61(4):e410-e413. doi:10.1111/ajd.13304Pirrone J, Böer-Auer A.Promyelocytic Differentiation in Infiltrates of Prurigo Pigmentosa: An Analogy to Histiocytoid Sweet Syndrome.Am J Dermatopathol.2020 Feb;42(2):86-91. doi:10.1097/DAD.0000000000001449Oztas M, Ugurlu S, Aydin O.Atorvastatin-induced dermatomyositis.Rheumatol Int. 2017 Jul;37(7):1217-1219. doi:10.1007/s00296-017-3658-9Sussman M, Napodano A, Huang S, Are A, Hsu S, Motaparthi K.Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis.Medicina (Kaunas). 2021 Sep 23;57(10):1004. doi:10.3390/medicina57101004Saito A, Okiyama N, Kubota N, et al.Blockade of Granzyme B remarkably improves mucocutaneous diseases with keratinocyte death in interface dermatitis.J Invest Dermatol. 2018;138(9):2079–2083. doi:10.1016/j.jid.2018.03.1507Wenzel J.Cutaneous lupus erythematosus: new insights into pathogenesis and therapeutic strategies.Nat Rev Rheumatol. 2019;15(9):519–532. doi:10.1038/s41584-019-0272-0Manchanda Y, Rathi SK, Joshi A, Das S.Oral lichen planus: An updated review of etiopathogenesis, clinical presentation, and management.Indian Dermatol Online J. 2023 Dec 22;15(1):8-23. doi:10.4103/idoj.idoj_652_22
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
El Hasbani G, Kibbi AG, Jawad A, Uthman I.Vacuolar interface dermatitis as a histologic reaction pattern of Sjögren’s syndrome: A case report.Cureus. 2023 Oct 3;15(10):e46412. doi:10.7759/cureus.46412Okiyama N, Yamaguchi Y, Kodera M, Hamaguchi Y, Yokozeki H, Ishiguro N,et al.Distinct histopathologic patterns of finger eruptions in dermatomyositis based on myositis-specific autoantibody profiles.JAMA Dermatol. 2019 Sep 1;155(9):1080-1082. doi:10.1001/jamadermatol.2019.1668Ehlert B, Shegos L, Franklin M, Buckley K, Rodger J.An atypical facial eruption in skin of color: A rare presentation of histiocytoid Sweet syndrome.JAAD Case Rep. 2024 Mar 9;47:6-9. doi:10.1016/j.jdcr.2024.02.027Akahoshi Y, Spyrou N, Hogan WJ, Ayuk F, DeFilipp Z, Weber D,et al.Incidence, clinical presentation, risk factors, outcomes, and biomarkers in de novo late acute GVHD.Blood Adv. 2023 Aug 22;7(16):4479-4491. doi:10.1182/bloodadvances.2023009885Stephan C, Abbas O, Bhawan J.Adnexotropic Variants of the Interface Dermatitides: A Review.Dermatopathology (Basel). 2021 May 21;8(2):135-146. doi: 10.3390/dermatopathology8020020.Journal of the American Academy of Dermatology.An atypical facial eruption in skin of color: A rare presentation of histiocytoid Sweet syndrome.Høgsberg T, Thomsen BM, Serup J.Histopathology and immune histochemistry of red tattoo reactions. Interface dermatitis is the lead pathology, with increase in T-lymphocytes and Langerhans cells suggesting an allergic pathomechanism.Skin Res Technol. 2015;21(4):449–458. doi:10.1111/srt.12213Choi ME, Yang HJ, Lee WJ, Won CH, Chang SE, Choi JH,et al.A case of cutaneous extranodal natural killer/T-cell lymphoma clinically and histopathologically mimicking interface dermatitis.Australas J Dermatol.2020 Nov;61(4):e410-e413. doi:10.1111/ajd.13304Pirrone J, Böer-Auer A.Promyelocytic Differentiation in Infiltrates of Prurigo Pigmentosa: An Analogy to Histiocytoid Sweet Syndrome.Am J Dermatopathol.2020 Feb;42(2):86-91. doi:10.1097/DAD.0000000000001449Oztas M, Ugurlu S, Aydin O.Atorvastatin-induced dermatomyositis.Rheumatol Int. 2017 Jul;37(7):1217-1219. doi:10.1007/s00296-017-3658-9Sussman M, Napodano A, Huang S, Are A, Hsu S, Motaparthi K.Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis.Medicina (Kaunas). 2021 Sep 23;57(10):1004. doi:10.3390/medicina57101004Saito A, Okiyama N, Kubota N, et al.Blockade of Granzyme B remarkably improves mucocutaneous diseases with keratinocyte death in interface dermatitis.J Invest Dermatol. 2018;138(9):2079–2083. doi:10.1016/j.jid.2018.03.1507Wenzel J.Cutaneous lupus erythematosus: new insights into pathogenesis and therapeutic strategies.Nat Rev Rheumatol. 2019;15(9):519–532. doi:10.1038/s41584-019-0272-0Manchanda Y, Rathi SK, Joshi A, Das S.Oral lichen planus: An updated review of etiopathogenesis, clinical presentation, and management.Indian Dermatol Online J. 2023 Dec 22;15(1):8-23. doi:10.4103/idoj.idoj_652_22
El Hasbani G, Kibbi AG, Jawad A, Uthman I.Vacuolar interface dermatitis as a histologic reaction pattern of Sjögren’s syndrome: A case report.Cureus. 2023 Oct 3;15(10):e46412. doi:10.7759/cureus.46412
Okiyama N, Yamaguchi Y, Kodera M, Hamaguchi Y, Yokozeki H, Ishiguro N,et al.Distinct histopathologic patterns of finger eruptions in dermatomyositis based on myositis-specific autoantibody profiles.JAMA Dermatol. 2019 Sep 1;155(9):1080-1082. doi:10.1001/jamadermatol.2019.1668
Ehlert B, Shegos L, Franklin M, Buckley K, Rodger J.An atypical facial eruption in skin of color: A rare presentation of histiocytoid Sweet syndrome.JAAD Case Rep. 2024 Mar 9;47:6-9. doi:10.1016/j.jdcr.2024.02.027
Akahoshi Y, Spyrou N, Hogan WJ, Ayuk F, DeFilipp Z, Weber D,et al.Incidence, clinical presentation, risk factors, outcomes, and biomarkers in de novo late acute GVHD.Blood Adv. 2023 Aug 22;7(16):4479-4491. doi:10.1182/bloodadvances.2023009885
Stephan C, Abbas O, Bhawan J.Adnexotropic Variants of the Interface Dermatitides: A Review.Dermatopathology (Basel). 2021 May 21;8(2):135-146. doi: 10.3390/dermatopathology8020020.
Journal of the American Academy of Dermatology.An atypical facial eruption in skin of color: A rare presentation of histiocytoid Sweet syndrome.
Høgsberg T, Thomsen BM, Serup J.Histopathology and immune histochemistry of red tattoo reactions. Interface dermatitis is the lead pathology, with increase in T-lymphocytes and Langerhans cells suggesting an allergic pathomechanism.Skin Res Technol. 2015;21(4):449–458. doi:10.1111/srt.12213
Choi ME, Yang HJ, Lee WJ, Won CH, Chang SE, Choi JH,et al.A case of cutaneous extranodal natural killer/T-cell lymphoma clinically and histopathologically mimicking interface dermatitis.Australas J Dermatol.2020 Nov;61(4):e410-e413. doi:10.1111/ajd.13304
Pirrone J, Böer-Auer A.Promyelocytic Differentiation in Infiltrates of Prurigo Pigmentosa: An Analogy to Histiocytoid Sweet Syndrome.Am J Dermatopathol.2020 Feb;42(2):86-91. doi:10.1097/DAD.0000000000001449
Oztas M, Ugurlu S, Aydin O.Atorvastatin-induced dermatomyositis.Rheumatol Int. 2017 Jul;37(7):1217-1219. doi:10.1007/s00296-017-3658-9
Sussman M, Napodano A, Huang S, Are A, Hsu S, Motaparthi K.Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis.Medicina (Kaunas). 2021 Sep 23;57(10):1004. doi:10.3390/medicina57101004
Saito A, Okiyama N, Kubota N, et al.Blockade of Granzyme B remarkably improves mucocutaneous diseases with keratinocyte death in interface dermatitis.J Invest Dermatol. 2018;138(9):2079–2083. doi:10.1016/j.jid.2018.03.1507
Wenzel J.Cutaneous lupus erythematosus: new insights into pathogenesis and therapeutic strategies.Nat Rev Rheumatol. 2019;15(9):519–532. doi:10.1038/s41584-019-0272-0
Manchanda Y, Rathi SK, Joshi A, Das S.Oral lichen planus: An updated review of etiopathogenesis, clinical presentation, and management.Indian Dermatol Online J. 2023 Dec 22;15(1):8-23. doi:10.4103/idoj.idoj_652_22
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