There have been no formal epidemiologic studies to determine the incidence or gender predilection of LCD. It is an uncommon disease that affects both men and women, the majority of whom are more than 40 years of age as described in the literature. LCD has not yet been described in the pediatric population.

Patients with LCD classically exhibit erythematous plaques and papules associated with pruritus and periods of remission and exacerbation (Fig. 51-1).^1,2 Some patients experience an exfoliative erythroderma.^3,4 Dusky nodules and tumors, infiltration, and scaling have also been described, though these features seem to be less common.^2,5,6 Diagnosis can be difficult because it hinges on identifying the offending contact allergen, so a thorough history and comprehensive patch testing are essential. Many allergens have been implicated in LCD (Table 51-1). In most instances, complete avoidance of the contact allergen will result in lasting remission without significant sequelae.^1,2,16 Cases of persistent pseudolymphomatous contact dermatitis developing into a florid cutaneous lymphoma have been described, but it is possible that these patients had a lymphoproliferative disorder to begin with. This was described by Abraham et al.¹⁷ in a patient initially diagnosed with LCD induced by topical eye treatments who was, years later, found to have latent T-cell prolymphocytic leukemia. This patient most likely had cutaneous involvement as the herald symptom of his leukemia rather than LCD.^17,18 It is important to note that 45% of patients with cutaneous lymphoma and 38% of patients with all pseudolymphomas had positive patch testing, often to metals. Therefore, it is capital to stress that a positive patch test should not be interpreted as a marker of a benign inflammatory disorder.^19,20,21