What is the initial management step for a patient with contact dermatitis?

The initial management step for a patient with contact dermatitis is the application of a topical steroid cream. This treatment is effective in reducing inflammation and alleviating itching associated with dermatitis. Topical steroids work by suppressing the inflammatory response in the skin, helping to relieve symptoms and promote healing.

In contact dermatitis, especially when the condition is localized and not widespread, topical steroids are preferred as they deliver anti-inflammatory effects directly to the affected area while minimizing systemic side effects that could occur with oral steroids. It's usually recommended to use a medium to high potency steroid, depending on the severity of the condition and the area of the body being treated.

Other options like oral steroids are typically reserved for more severe or widespread cases where topical treatments are insufficient. Antihistamines can help with itching but do not address inflammation, making them a secondary option rather than a first-line treatment. A skin biopsy is generally not indicated for initial management but may be considered in atypical cases or when distinguishing it from other skin conditions. Hence, the use of a topical steroid cream stands out as the most immediate and effective initial approach to manage contact dermatitis.