Other types of atopic dermatitis Flashcards
types of atopic dermatitis
Atopic dermatitis (eczema)
Nummular (discoid) eczema
Pityriasis alba
Lichen simplex chronicus
Dyshydrotic dermatitis (pompholyx)
Asteatotic dermatitis (‘winter itch’)
Nummular (discoid) eczema
Chronic, red, coin-shaped plaques
Crusted, scaling and itchy
Mainly on the legs, also buttocks and trunk
Treatment as for classic atopic dermatitis
Pityriasis alba
These are white patches on the face of children and adolescents.
Can occur on the neck and upper limbs, occasionally on trunk.
Full repigmentation occurs eventually.
Treatment
- Reassurance
- Simple emollients
- Restrict use of soap and washing
- May prescribe hydrocortisone ointment (rarely necessary)
Lichen simplex chronicus
Circumscribed thick plaques of lichenification
Caused by repeated rubbing and scratching of previously normal skin
Due to chronic itch of unknown cause
Treatment
- Explanation
- Refrain from scratching
- Potent topical corticosteroid ointment (with or without occlusion) to break the itch–scratch cycle
Dyshydrotic dermatitis (pompholyx)
Itching vesicles on fingers
May be larger vesicles on palms and soles
Commonly affects sides of digits and palms
Often triggered by high humidity
Treatment
- Wet dressings/soaks if severe
- As for atopic dermatitis, although use a cream for exudative phase, then ointment as the skin dries
- Potent fluorinated corticosteroids topically use under occlusion (e.g. damp cotton glove)
- Oral corticosteroids for 3 weeks may be necessary
Asteatotic dermatitis (‘winter itch’)
It is a form of eczema that occurs in the elderly subjected to considerable scrubbing and bathing.
- common
- often unrecognised
- very itchy dermatitis
- with a dry ‘crazy paving’ pattern, esp. on the legs.
Other predisposing factors include:
- low humidity (winter, central heating)
- diuretics.
Treatment
- Avoid scrubbing with soaps
- Use aqueous cream and a soap substitute
- Apply topical steroid diluted in white soft paraffin
