DERMATITIS

Definition :
Dermatitis is defined as a series of inflammatory changes in the
skin induced by external or internal or internal ( constitutive)
factors.
Morphological features :
Acute stage : Erythema, oedema, papules, vesicles,oozing &
crusting.
Subacute stage : Scaling, Lichenification, fissuring and
hyperpigmentation .
Histologically :
Determatitis reaction may be acute, subacute or chronic
Acute determatitis is charactrised by considerable spongiosis
( interacellular oedema ) that may lead to formation of
intraepidermal vesicles or bullas.
Chronic dermatitis shows hyperkeratosis with elongation of the
rete ridges and broadened dermal papillae.
A combination of those two patterns is seen in the subacute stage.
Classification :
A ] Exogenous Dermatitis
i. Contact dermatitis
ii. Photollergic dermatitis
iii. Photocontact dermatitis
iv. Infectious Dermatitistoid
 B] Endogenous Dermatitis :
i. Atopic dermatitis
ii. Seborrhoec dermatitis
iii. Discoid eczma
iv. Pompholyx
v. Stasis dermatitis
vi. Lichen Simplex
A] Exogenous Dermatitis :
i. Irritant contact dermatitis :
It occurs as a result of the skin coming in contact with irritants
which cause an altered state of sensation (burning, stinging) and
some morphologic changes.
eg. : Cleansers, soaps, detergents, organic solvents etc.
ii. Allergic contact dermatitis :
It is a disorder of the skin resulting from a delayed
hypersensitivity reaction mediated by T-lymphocytes against
certain chemicals causing sensitization on coming in contact with
the skin
iii. Photoallergy and phototoxity :
For Photoallergy and Phototoxity reactions an interaction
between the chemical and solar radiation is required.
B] Endogenous Dermatitis :
i. Atopic Dermatitis :
 It is a chronic relapsing pruritic skin disorder of unknown
aetiology, associated with personal & or family history of atopy
& a typical distribution and morphology.
It is characterised by itchy lichenified lesion in the cubital of
popliteal fossae, sides of the neck, wrist and ankles.
ii. Seborrhoeic determatitis :
It is a chronic dermatitis with a typical distribution in the areas
with a rich supply of sebaceous glands & erythematous
papulosquamous lesions with greasy scales.
iii. Discoid or nummular Dermatitis :
It is characterised by pruritic circular or oval lesions with closely
set papulovesicles on an erythematous base.
iv. Pompholyx :
Type of vesicular Dermatitis with chronic & recurrent lesions
affecting palms, soals & sides of fingers .Lesions are deep seated,
sago like vesicles which are intensly pruritic.
v. Stasis dermatitis :
It occurs in middle – aged or elderly patients around the ankles as
a result of venous hypertension.
vi. Lichen Simplex Chronicus :
Termed nuerodermatitis, lichen simplex chronicus is caused by a
vicious circle involving an itch – scratch – itch response.

 Homoeopathic Approach to Dermatitis

1] Graphites :
 - Indicated for Dermatitis of lids, eruption moist and
fissured.
- Lids red and margins covered with scales or crusts.
- Unhealthy skin
- Erruptions oozes a watery, transparent, sticky fluid.
2] Arsenicum Album :
- It is the best remedy for the chronic form of Dermatitis
with the great burning and itching.
- Skin dry and scaly, cold blue and wrinkled with cold,
clammy perspiration like parchment, white and pasty, black
vesicles and burning pain
3] Sulphur :
- Well indicated for Dermatitis erythematosam
- Complaints are aggravated from washing
- With scratching makes the parts burn intensely.
- Dryness and heat of scalp.
- Eruptions at the margin of hair.
- Intense itching especially at night.
4] Petroleum :
- Petroleum pictures pure Dermatitis with its thick, scabs,
oozing pus and rhagades. The skin is harsh and dry, the
finger toes crack and the hands chap.
- It is especially suitable to Dermatitis behinds the ears.
5] Vinca minor :
- Dermatitis of scalp and face matted hair and offensive
odour.
- A crust is formed, the discharge is retained underneath and
causes the hair to fall out or to mat together, forming the
plica polonica.