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asteatotic dermatitis; eczema craquelatum; xerotic eczema; winter itch

Etiology: 1) xerosis, aging [3] 2) too frequent bathing with hot soapy water 3) high environmental temperature with low humidity 4) pharmaceuticals - beta-blockers: atenolol Epidemiology: - common pruritic dermatitis, especially a) males over 60 b) winter months Pathology: 1) decreased sebum production (intrinsic aging) 2) spongiosis Clinical manifestations: 1) xerosis (dry skin), pruritus 2) occurs on the legs, arms, hands & occasionally trunk 3) characterized by dry, cracked, fissured skin with slight scaling 4) tile or plate-like erythematous pattern on dry skin with excoriations due to scratching [3] 5) may persist for weeks to months * images [4] Management: 1) avoid overbathing 2) increase ambient humidity 3) application of emollients after bathing 4) medium potency corticosteroid topical agent BID until resolution of eczema

General

eczematous dermatitis (eczema)

References

  1. Color Atlas & Synopsis of Clinical Dermatology, Common & Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY, 1997, pg 77
  2. Takahashi S: UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 29-Oct 2, 2004
  3. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015 - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  4. DermNet NZ. Eczema craquele (images) http://www.dermnetnz.org/dermatitis/eczema-craquele.html