Atopic dermatitis
Presentation
- Chronic itchy skin condition
- Can occur at any age, but less common with increasing age
- Associated with other atopic conditions, such as asthma, hay fever and rhinitis
- Often a genetic component
- Underlying problem is a defect in skin barrier function
- Stress, viruses and teething in babies common triggers
- Secondary infection common
Management
- Emollients are mainstay, but avoidance of triggers important
- Topical steroids or immunosuppressants usually required
- Severe cases may require second-line oral therapy
Irritant contact dermatitis
Presentation
- Eczematous reaction that can occur anywhere on the body when chemicals or physical damage injure skin faster than it can repair itself
- Severity related to exposure, strength of irritant, environmental factors and individual susceptibility
- Can affect anyone
Management
- Specific tests not usually required
- Management aims to reduce contact with irritants
- Emollients, topical steroids can be helpful once dermatitis has developed
- If secondary infection, antibiotics may be required
Allergic contact dermatitis
Presentation
- Allergic dermatitis secondary to contact with a specific allergen
- Reaction usually only where contact has occurred
- Recurrent reaction secondary to each exposure
- Can affect anywhere on the body; in this case, allergen was latex
- May occur hours after exposure
- Affected areas commonly itchy, red and swollen; may blister
Management
- Patch testing can be useful in identifying allergens
- Mainstay is avoiding allergens
- Once dermatitis develops, emollients and topical steroids can help
Pompholyx
Presentation
- Common type of eczema, affects hands and feet
- Flares more common in hot weather or at times of stress
- Can follow fungal infection
- Occurs as deep-seated crops of blisters
- Usually associated with burning sensation and intense pruritus
Management
- Includes cool compresses
- Emollients can be helpful
- Potent topical steroids usually required
- In severe cases, psoralen-UVA or systemic steroids may help
- In chronic cases, methotrexate, dapsone or azathioprine may help
Dr Stollery is a GP in Leicestershire
