Dermatitis

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Dermatitis refers to inflammation of the skin that can present with redness, swelling, itching, and sometimes blisters or crusting. It is a common condition with multiple subtypes, including atopic dermatitis (eczema), contact dermatitis, seborrheic dermatitis, and stasis dermatitis.

Signs & Symptoms

Symptoms of dermatitis vary depending on the type but commonly include:

  1. Atopic Dermatitis:

    • Red, itchy patches, often on the face, elbows, knees, or hands.
    • Dry, scaly skin.
    • Cracks or sores from scratching.

  2. Contact Dermatitis:

    • Redness, swelling, and blisters in areas exposed to irritants or allergens.
    • Itching or burning sensations.
    • Crusty or weepy skin after repeated exposure.

  3. Seborrheic Dermatitis:

    • Greasy, yellowish scales on the scalp (dandruff) or face.
    • Flaking skin around the nose, ears, or eyebrows.
    • Mild redness or swelling.

  4. Stasis Dermatitis:

    • Swelling in the lower legs.
    • Brownish discoloration of the skin.
    • Ulcer formation in severe cases.

Anatomy Affected

Dermatitis primarily affects the epidermis (outer layer of the skin) and sometimes extends into the dermis (inner layer). Specific areas affected depend on the type of dermatitis:

  • Atopic dermatitis often affects the folds of the skin.
  • Contact dermatitis occurs where the skin directly contacts an allergen or irritant.
  • Seborrheic dermatitis typically targets areas with oil glands.
  • Stasis dermatitis affects the lower extremities due to poor blood flow.

Causes and Transmission

Dermatitis is not contagious but can result from various triggers:

  1. Atopic Dermatitis: Linked to genetics, immune dysfunction, and environmental factors. It often coexists with asthma or hay fever.
  2. Contact Dermatitis:
    • Irritant Contact Dermatitis: Caused by chemicals or harsh substances like detergents or solvents.
    • Allergic Contact Dermatitis: Triggered by allergens like nickel, latex, or poison ivy.
  3. Seborrheic Dermatitis: Linked to an overgrowth of yeast (Malassezia) on the skin, oiliness, or stress.
  4. Stasis Dermatitis: Caused by chronic venous insufficiency leading to fluid accumulation in the legs.

Treatments

Treatment depends on the type and severity of dermatitis:

  1. General Measures:

    • Avoid triggers like allergens, harsh soaps, or environmental irritants.
    • Use gentle, fragrance-free moisturizers to maintain the skin barrier.

  2. Medications:

    • Topical corticosteroids to reduce inflammation.
    • Antihistamines for itch relief.
    • Calcineurin inhibitors (e.g., tacrolimus) for sensitive areas.
    • Antifungal creams for seborrheic dermatitis.

  3. Lifestyle Changes:

    • For seborrheic dermatitis, medicated shampoos with ketoconazole or selenium sulfide can help.
    • For stasis dermatitis, leg elevation and compression stockings improve blood flow.

  4. Severe Cases:

    • Systemic medications like oral corticosteroids, immunosuppressants, or biologics for atopic dermatitis.

Prevention

While some forms of dermatitis cannot be entirely prevented, the risk of flare-ups can be minimized through:

  • Regular use of moisturizers to maintain the skin barrier.
  • Identifying and avoiding triggers (e.g., allergens, irritants).
  • Wearing protective clothing or gloves when working with chemicals.
  • Managing stress, which can exacerbate certain types like seborrheic dermatitis.

Prognosis/Outlook

  • Atopic Dermatitis: Chronic but manageable. Many children outgrow it by adulthood.
  • Contact Dermatitis: Resolves once the irritant or allergen is removed. Chronic exposure can lead to persistent symptoms.
  • Seborrheic Dermatitis: Often requires ongoing treatment but does not cause long-term harm.
  • Stasis Dermatitis: May lead to complications like leg ulcers if untreated. Improved circulation and consistent care yield a good prognosis.

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