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Dermatitis - a Distressing Disease

Written by
Dr. Suvash Sahu
and medically reviewed by iCliniq medical review team.

Published on Jul 28, 2016 and last reviewed on Jun 16, 2021   -  5 min read


This article discusses various phases of dermatitis (also known as eczema) with their causes and management.

Dermatitis - a Distressing Disease

What Is Dermatitis?

Dermatitis means inflammation of the skin. It is also known as eczema, a group of skin conditions with different causes but clinically similar presentations. These are defined as skin inflammation patterns having characteristic morphologies during their acute, subacute, and chronic phases.

What Are The Causes of Dermatitis (Eczema)?

Eczema can be caused by dust mites, pet dander, pollen, and certain foods, but the exact cause is not known, but it is linked with the overactive response of the body's immune system.

The risk factors include:

What Are the Symptoms of Eczema?

Symptoms may include:

What Are the Phases of Eczema?

  1. Acute phase.

  2. Subacute phase.

  3. Chronic phase.

1. Acute Phase:

There will be erythema or redness in the acute phase, edema or swelling, vesiculation or fluid-filled lesions, discharge, and crusting.

2. Subacute Phase:

The subacute phase exhibits hyperpigmentation, scaling, and crusting.

3. Chronic Phase:

In the chronic phase, there will be lichenification. It is a combination of thickening, hyperpigmentation, and prominent skin markings.

How Can Eczema Be Classified?

It can be divided into two groups. They are,

  1. Exogenous eczemas.

  2. Endogenous eczemas.

Exogenous Eczemas:

Exogenous eczemas could either be irritant or allergic in nature.

1. Irritant Contact Dermatitis:

Itis a type of eczema caused by many agents whose toxins or excretory products cause a variable degree of involvement depending upon their concentration and duration of contact with the skin of everyone exposed to them.

These agents can be any of the following:

  1. Chemical: Detergents, soaps, acids, etc.

  2. Physical: Sunlight, heat, etc.

  3. Biological: Bacteria, viruses, mites, lice, etc.

2. Allergic Contact Dermatitis:

3. Air-borne Contact Dermatitis(ABCD):

How Is Dermatitis Diagnosed?

The diagnosis of allergic contact dermatitis can be established by doing a patch test, in which patches of suspected allergens in appropriate concentrations are put on the non-hairy skin of the back or arms, and readings were taken after 48-72 hours. The positive patch test reaction is indicated by redness or fluid-filled eruptions or ulceration at the test site.

Endogenous Eczemas:

Some common types of endogenous eczemas are as follows.

1. Atopic Dermatitis:

Atopic dermatitis is chronic eczema. It is one of the atopic conditions, together with asthma and hay fever, which has a heritable tendency.

2. Seborrheic Dermatitis:

There is an excessive sebum secretion in this type of eczema, presenting with scaly, itchy lesions over the scalp, nasolabial folds, sternal areas, and body folds.

3. Discoid Eczema:

Discoid eczema is a chronic recurrent discrete coin-shaped red area covered with exudates that crust over the limbs and trunk of the middle-aged due to unknown causative factors. Sometimes, it is very difficult to distinguish discoid eczema from psoriasis.

4. Pompholyx:

In this type of eczema, vesicular eruptions are generally seen on the palms or soles. The lesions may be non-inflammatory, chronic, and recurrent. The exact cause of pompholyx is not known.

General Principles of Therapy:

How Can Eczema Be Treated Locally?

Treatment for Acute Stage:

Normal saline or potassium permanganate (1:10,000 dilution) compresses or soaks are given to wash away serous discharges, crust, and debris, and it also helps to reduce oozing and inflammation. Calamine lotion should not be used. In case of discharge, avoid ointments or creams. Corticosteroids can be given in lotion form.

Treatment for Subacute Stage:

When there is no oozing or discharge or in cases of subacute or dry eczemas, corticosteroid cream can be applied twice a day locally. Local antibiotic cream with or without corticosteroid is helpful where bacteria is present.

Treatment for Chronic Stage:

When the skin becomes thick or lichenified, occlusive dressing with a corticosteroid ointment is required. Alternatively, a moderately potent corticosteroid ointment can be applied locally two to three times a day. The addition of 3% Salicylic acid to the corticosteroid ointment is beneficial.

How Can Eczema Be Treated Systemically?

It is required in widespread acute or subacute cases and selected chronic cases.

Diet Recommended in Eczema:

Foods to Eat:

Foods to Avoid:

How To Prevent Eczema?

What Are The Complications of Eczema?

Excessive scratching may lead to bacterial or fungal infections of the skin.

Last reviewed at:
16 Jun 2021  -  5 min read




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