RECALCITRANT ATOPIC ECZEMA

Diagnosis: RECALCITRANT ATOPIC ECZEMA

Case submitted by Dr.Azeem Alam Khan to the dermRounds community.

Clinical Presentation

Clinical photograph(s) submitted for peer review and discussion.

Clinical History

Submitted by Dr.Azeem Alam Khan. Originally posted June 10, 2009.

Treatment

See case discussion.

Differential Diagnosis

• Psoriasis • Contact dermatitis • Scabies • Tinea corporis • Seborrheic dermatitis • Mycosis fungoides • Drug eruption

Key Learnings

• "Eczema" is a clinical pattern, not a single diagnosis — encompasses multiple subtypes • Impaired skin barrier function is central to pathogenesis • Spongiosis (intercellular edema in epidermis) is the histological hallmark • Acute: vesicles, weeping. Subacute: erythema, scale. Chronic: lichenification, fissuring • Superinfection with S. aureus is common and may cause flares

Tags: recalcitrant, atopic, eczema, dr.azeem alam khan