Itching, Redness

of the skin
Hannah K Damar

Factors Influence the Skin

Climate
Race
Sex
Chemicals
Radiation
Sun Exposure
Intrinsic factor

Key Of Dermatologic Diagnosis

Skin changes are the chief complaint
Visible to the unaided eye
Clinically recognized

Examination
- Primary Skin Lesions
- Secondary Skin Lesions
- Number

- Distribution
- Arrangement of lesion
- Shape
- Border

Palpate

Smell

What is Ms Lentiks problem ?

She had an irritation from washing of her hand to often
dry skin especially on the soft skin : the web
She experience allergy to the Telon oil Type IV allergy
(Coombs & Gell )
She exposed to the other irritant substance & got a
secondary infection.
The skin sign was altered according to the cause of the
disease

Eczema Key Points :

Appearance various from blisters to scalling
plaques
Itching is prominent
Distribution can be localized, diffused or
generalized
Indistinct borders (except for contact
dermatitis )

Histologically
Acute : Intercellular edema ( spongiosis ),
Intercellular edema,
Enlargement of blood vessels,
Exocytosis especially mononuclear
cells and eosinophil
Sub acute: Mild achantosis,
Exocytosis

Histologically
Chronic :
Achantosis
Hyperkeratosis
Para keratosis
Slight spongiosis
Thickening of vascular wall
Fibroblast & collagen deposition
Hiperpigmentation

Clinical appearance
Acute dermatitis causing vesicles,
Subacute dermatitis appear as juicy papules
Chronic dermatitis involves thickening
epidermis ( lichenification)

Eczematous eruptions
Etiology
Atopic dermatitis
Seborhoic dermatitis
Contact dermatitis
Static dermatitis
Lichen simplex chronicus

Answer to questions
What is your diagnosis ?
Contact dermatitis with secondary infection

What is your differential diagnosis ?

First stage :

- Contact allergy dermatitis

- Contact irritant dermatitis
- Tinea manum
Second stage :- Dyshidrosis
- Scabies
- Tinea manum
Third stage : - Impetigo
- Dyshidrosis
- Dermatitis herpetiform

Laboratory test
Culture of exudate
How would you prove your diagnosis ?
Patch test

If you suspect an allergy, What is the most

likely cause?
Telon oil

How you treat the patient ?

Stop causative allergen
How would you determine the prognosis of
this patient ?
Ad Vitam
Ad Sanationam
Ad Cosmeticam

Ad bonam
Ad bonam
Ad bonam

How you treat the patient ?

What precautions should the patient take
in the future ?
Maintain skin integrity
Dont expose to chemical allergen
Pay more attention on skin irritation

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