Dermatitis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Dermatitis
Synonyms	Eczema
Pronounce	N/A
Specialty	N/A
Symptoms	Itchiness, redness, swelling, cracking, blisters
Complications	Skin infection, sleep problems
Onset	Childhood or adulthood
Duration	Long term
Types	N/A
Causes	Genetic, environmental
Risks	Family history, allergies
Diagnosis	Physical examination, medical history
Differential diagnosis	Psoriasis, scabies, contact dermatitis
Prevention	Avoiding irritants, moisturizing
Treatment	Moisturizers, steroid creams, antihistamines
Medication	Corticosteroids, immunosuppressants
Prognosis	N/A
Frequency	Common
Deaths	Rare

Dermatitis is a general term that describes inflammation of the skin. It can have various causes and manifestations, but its hallmark is usually an itchy rash. Dermatitis can be acute or chronic and affect people of all ages.

Seborrhoeic dermatitis head

Common causes of dermatitis and skin irritants

Micrograph of dermatitis herpetiformis

Dermatitis herpetiformis

Types of Dermatitis

There are several different types of dermatitis, including:

1. Atopic dermatitis (eczema): A chronic skin condition characterized by itchy, inflamed skin, often occurring in individuals with a family history of allergies or asthma.
2. Contact dermatitis: A localized reaction that occurs when the skin comes into contact with an allergen or irritant, such as poison ivy or a particular chemical.
3. Seborrheic dermatitis: A common skin condition that causes redness, scaling, and dandruff, primarily affecting the scalp, face, and trunk.
4. Stasis dermatitis: A skin inflammation that occurs in individuals with poor circulation, particularly in the lower legs.
5. Nummular dermatitis: Characterized by coin-shaped patches of irritated skin, this type of dermatitis is more common in older adults and can be triggered by dry skin or injury.

Causes and Risk Factors

The exact cause of dermatitis varies depending on the type, but common factors include:

• Genetic predisposition
• Environmental factors, such as exposure to allergens, irritants, or extreme weather conditions
• Weakened skin barrier function
• Immune system dysfunction
• Poor circulation
• Stress

Risk factors for dermatitis include:

• Personal or family history of allergies, asthma, or other atopic conditions
• Frequent exposure to irritants or allergens, particularly in occupational settings
• Age (certain types of dermatitis are more common in specific age groups)
• Skin type (individuals with dry or sensitive skin may be more prone to dermatitis)

Symptoms

Common symptoms of dermatitis include:

• Red, inflamed skin
• Itching
• Swelling
• Scaling or flaking
• Crusting or oozing
• Blisters or vesicles
• Pain or tenderness

Diagnosis

Dermatitis is typically diagnosed by a dermatologist through a combination of medical history, physical examination, and, if necessary, diagnostic tests. These tests may include: Patch testing: Used to identify specific allergens causing contact dermatitis Skin biopsy: A small sample of skin is removed and examined under a microscope to confirm the diagnosis and rule out other skin conditions Blood tests: These may be used to assess immune system function or identify specific allergens

Treatment

The treatment for dermatitis depends on the type and severity of the condition. The primary goals of treatment are to alleviate symptoms, reduce inflammation, and prevent future flare-ups. Common treatment options include:

• Topical corticosteroids: These medications help to reduce inflammation and itching.
• Antihistamines: Oral antihistamines can help to control itching, particularly in cases of atopic dermatitis.
• Moisturizers and emollients: Regular use of moisturizers and emollients can help to maintain the skin's barrier function and prevent dryness.
• Topical calcineurin inhibitors: These medications, such as tacrolimus and pimecrolimus, can be used as an alternative to corticosteroids in certain cases.
• Phototherapy: Controlled exposure to ultraviolet light can help to reduce inflammation and improve symptoms in some cases of dermatitis.
• Lifestyle changes: Identifying and avoiding triggers, such as allergens or irritants, can help to prevent flare-ups.

Prevention

Preventive measures for dermatitis include:

• Identifying and avoiding known allergens or irritants
• Maintaining good skin hygiene and using gentle, fragrance-free cleansers
• Regularly using moisturizers and emollients to maintain skin barrier function and prevent dryness
• Using protective clothing or gloves when handling irritants or allergens, particularly in occupational settings
• Managing stress, as it can contribute to dermatitis flare-ups
• Avoiding excessive exposure to extreme temperatures or weather conditions

Complications

Potential complications of dermatitis include: Skin infections: Scratching or damaged skin can allow bacteria or other pathogens to enter, potentially leading to infection. Scarring or skin discoloration: Chronic inflammation or scratching may result in changes to the skin's appearance. Impact on quality of life: Persistent itching and discomfort can negatively affect sleep, daily activities, and overall well-being.

See Also

• Psoriasis
• Rosacea
• Urticaria (Hives)

References

• American Academy of Dermatology. (n.d.). Dermatitis. Retrieved from https://www.aad.org/public/diseases/a-z/dermatitis-overview
• Bolognia, J. L., Schaffer, J. V., & Cerroni, L. (Eds.). (2018). Dermatology (4th ed.). Elsevier.

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