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dermatitis
Inflammation of the skin.
Classification:
1) acute
a) macroscopic spongiosis with vesicles & bullae
b) examples:
- contact dermatitis of poison oak or ivy
- hypersensitivity of acute neutrophilic dermatosis
2) subacute
- erythema & crusting, but no vesiculation
- microvesiculation seen on histology
3) chronic
a) lichenification
b) post-inflammatory pigmentary changes
- hyperpigmentation
- hypopigmentation
Etiology:
1) exogenous
a) contact dermatitis of poison oak or ivy
b) hypersensitivity of acute neutrophilic dermatosis
2) endogenous
a) dyshidrotic eczema
b) stasis dermatitis
c) pharmaceuticals
3) also see differential diagnosis of skin lesions by body region
Pathology:
1) inflammation of the epidermis
2) epidermal spongiosis
Clinical manifestations:
1) exogenous (contact dermatitis)
a) irregular configuration of lesions
b) linear configuration of lesions or sharp angles
c) distribution of rash may suggest diagnosis
- rash in areas where jewelry is worn suggests contact dermatitis due to nickel hypersensitivity
2) endogenous dermatitis
-> rounded borders
Differential diagnosis:
1) contact dermatitis
2) atopic dermatitis
3) asteatotic dermatitis
4) lichen simplex chronicus
5) rash associated with skin infection
Management:
1) topical glucocorticoids
- caution: tachyphylaxis may occur with prolonged treatment of endogenous eczema
2) remove/avoid offending agent(s)
3) probiotics not useful [4]
Interactions
disease interactions
Related
differential diagnosis of skin lesions by body region
lichenification
rash
skin lesion
Specific
acne keloidalis nuchae; folliculitis keloidalis
acrodermatitis
chondrodermatitis nodularis chronica helicis (Winkler disease)
coral dermatitis
cutaneous vasculitis; predominantly cutaneous vasculitis
dermatomyositis
diaper rash
eczematous dermatitis (eczema)
erucism (caterpillar dermatitis)
erythema dyschromicum perstans; ashy dermatosis
erythroderma (exfoliative dermatitis)
exfoliative erythroderma
figurate dermatitis (rings, arcs)
hand dermatitis
id reaction (autoeczematous reaction)
moisture-associated skin damage (MASD)
neurodermatitis
papulosquamous dermatitis
periorbital dermatitis
pseudofolliculitis barbae; pili incarnati
psoriasiform dermatitis; psoriaform dermatitis
pustular dermatitis
radiodermatitis (radiation dermatitis)
seborrheic dermatitis; seborrhea; cradle cap (infants)
skin maceration
vesiculobullous dermatitis
General
inflammation
skin disease (dermatologic disorder, dermatopathy, dermatosis)
References
- Harrison's Principles of Internal Medicine, 13th ed.
Companion Handbook, Isselbacher et al (eds), McGraw-Hill
Inc. NY, 1995, pg 829-39
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- Harrison's Principles of Internal Medicine, 14th ed.
Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 298
- Boyle RJ et al.
Probiotics for treating eczema (Review).
Cochrane Database Syst Rev 2008 Oct 8.
PMID: 18843705
http://dx.doi.org/10.1002/14651858.CD006135.pub2
- Leung DY et al.
New insights into atopic dermatitis.
J Clin Invest 2004 Mar 3; 113:651
PMID: 14991059
- Chan CX, Zug KA.
Diagnosis and management of dermatitis, including atopic, contact, and hand eczemas.
Med Clin North Am. 2021;105:611-26.
PMID: 34059241
- The National Eczema Society.
http://www.eczema.org/