Diagnosis: Dermatitis
People with severe eczema often are placed on highly restrictive diets because of the fear that certain foods may trigger a flare-up. In addition to the nutritional deficiencies and quality-of-life is. Clinical photograph sourced from Wikimedia Commons (CC BY 2.0). Attribution: NIAID.
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