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Dermatitis Terbaru
Dermatitis Terbaru
DERMATITIS -Eczema
Eflorescense of Dermatitis-Eczema
Erythem
Papule
Vesicle
Pustule
Oozing
Crust
Squama
Atopic dermatitis
Contact dermatitis
Seborrhoic dermatitis
Statis dermatitis
Neurodermatitis
Nummular eczema
Dishidrosis
Asteatotic eczema
Infective Eczematoid Dermatitis
Adult
Infantile
Infantil
AD
Childhood AD
The classic locations are the antecubital, and the popliteal spaces,
the wrist, eyelids, and the face and in collarette about the neck
Itching
Childhood AD
Usually the eruption involves the antecubital and popliteal fossae, the
front and sides of the neck, the forehead and the are about the eyes
Hands dermatitis occurs more frequently in atopic individuals, and
eczematous lessions of the dorsum are usual
Pruritus : paroxysm, nocturnal, triggered by acute emotional stress
Trigger factors : rough clothing, wool irritation, foods or tension.
Associated features
Susceptibility to infection
:
S.aureus, generalized Herpes simplex or vaccinia virus
infections to produce Kaposis varicelliform eruption
Diagnosis
Hanifin & Rajka , Svenson, SCORAD criterias
Hanifin & Rajka criteria :
Major criteria
1.
Pruritus
2.
Typical morphology and distribution
3.
Tendency toward chronics or chronically relapsing dermatitis
4.
Personal or family history of atopic diseases (asthma, allergic
rhinitis, AD)
Minor criteria :
1.
Xerosis / ichthyosis/ hyperlinear palms
2.
Pityriasis alba
3.
Keratosis pilaris
4.
Facial pallor / infraorbital darkening
5.
Elevated serum IgE
6.
Keratoconus
7.
Tendency to non spesific hand eczema
8.
Tendency to repeat cutaneous infections
Differential diagnosis
Nummular Dermatitis
Seborrhoic Dermatitis
Contact Dermatitis
Psoriasis
Scabies
General management
1.
b.
Antihistamin systemically
c.
d.
2.
In adults :
a. The emotional stress should be controlled
b. Avoid extremes cold and heat
c. Hydrated xerotic skin
d. Antihistamin
e. Topical steroid ( be aware of the potentiality)
f. Antiobiotics ( if needed)
Irritants:
strong irritant severe inflamation at the first
contact
Weak irritants: less toxic substances which require
repeated or prolinged conatact to
cause inflamation (detergent,
organic solvents, excessive
exposure to water)
Incidence:
The incidence of cases of ICD (each type)
depending mainly on the degree of exposure and
the causative agent
In patients with atopic dermatitis there is a
relatively high incidence of ICD
Sign
Allergic dermatitis
Based on erythematous skin there are : edema,
papules, vesicles and occasionally bullae. Patches are
single / multiple, and of various size and shape. Strong
irritant burns, ulcer and necrosis
Patch Test
Treatment
Preventive :
Once the causative agent has been identified, further
contact should be avoided
Topical therapy :
in acute state : wet dressing : Burowi solution 1/20 1/40,
Permanganate 1/10.000, followed by topical steroid.
in chronic state : moderate topical steroid
Systemic therapy :
Antihistamin (severe pruritus) and steroid (severe /
ex tensive eruption
Contact Dermatitis
Seborrhoic dermatitis
Two distinct subset of patients :
* The Infantile form *
Characterized by large yellowish scale mainly on the scalp,
face, axilla and napkin rash
May cause confusion with Infantile Atopic Dermatitis
No link between the infantile and adult form
No pruritus eat & sleep well
Cradle Cap
Differential diagnosis :
Contact dermatitis, psoriasis and Pityriasis versicolor
Treatment :
Tends to recure whatever treatment is chosen
Topical : imidazol antifungal ketokonazol
(cream/shampoo) , weak potency topical steroid
Stasis dermatitis
Treatment :
treatment of underlying varicose veins, topical steroid (weak)
be ware of side effects atrophy
Stasis Dermatitis
Neurodermatitis
(liken simplex chronicus)
Treatment :
Reduce pruritus, topical steroid (ointment/
intra lesion)
Neurodermatitis
Asteatotic aczema
(eczema craquele)
The skin is dry and has large scale with a crazypaving appearance.
Treatment : - lubrication
- steroid topical should be avoided
(skin is already thin and fragile)
Asteatotic
Eczema
Dishydrotic
(eczema dishydrosticum)
Dishydrotic
Nummular or Discoid
Dermatitis
INFECTIVE ECZEMATOID
DERMATITIS
Clinical appearances :
Erythema & exudation
In a dry state, there is crust. If crust is peeled, we would
see erythema & often pustules on the edges
Examples :
The earlobes of children suffering from OMP.
The area around the nose of maxilaris sinusitis sufferers
Therapy :
Rivanol 1/1000, Betadine dressing
When cleared Hidrocortisone 1 % or combination with
antibiotic
Infective Eczematoid
Dermatitis