Diagnosis: Dermatitis
A Merlin Is Made- the Production of Merlin Engines at a Rolls Royce Factory, 1942 A view of the notice board at this aircraft engine factory, somewhere in Britain. Notices for dances and other social. Clinical photograph sourced from Wikimedia Commons (Public domain). Attribution: Richard Stone.
Acute: erythema, vesicles, weeping, crusting. Subacute: erythema, scale, excoriation. Chronic: lichenification, hyperkeratosis, fissuring. Distribution provides diagnostic clues — flexural (atopic), linear/geometric (contact), scalp/nasolabial (seborrheic).
Personal/family atopy history for atopic dermatitis. Occupational and hobby exposures for contact dermatitis. Chronic venous insufficiency for stasis dermatitis. Impact on quality of life and sleep should be assessed.
Emollients as foundation. Topical corticosteroids (strength matched to site/severity). Calcineurin inhibitors for sensitive areas. Dupilumab for moderate-severe atopic dermatitis. Phototherapy for widespread disease.
Psoriasis, Dermatophytosis, Scabies, Cutaneous T-cell lymphoma, Nummular dermatitis
The 'outside-in' vs 'inside-out' paradigm: contact dermatitis is triggered externally while atopic dermatitis has underlying barrier dysfunction. Patch testing differentiates allergic from irritant contact dermatitis.
Tags: dermatitis, eczema, inflammatory, pruritic