2 D. MOIST/OOZING ECZEMATOUS DERMATITIS LESION ATOPIC DERMATITIS 1.) Moist plaques with crust 2.

) Multiple intensely pruritic erythematous plaques with scaling and excoriations 3.) Erythematous lichenification with accentuation of skin margins AGE OF PREDILECTION 2mo 1y/o AREA OF PREDILECTION Nape, antecubitals and popliteal fossa HALLMARK Dennie Morgan Fold Hertoghes sign Headlight sign Tache blanche ETIOLOGY Associated with immunological imbalance; Significantly increased Ig E PREDISPOSING FACTORS TREATMENT Temporarily improved with topical steroids OTHER INFO Appeared on the area where diclofenac gel was applied Diagnostic criteria has been modified for young children and this includes: pruritus, typical facial or extensor dermatitis, history of atopic disease Dry Infantile Atopic Dermatitis associated with xerosis (dry skin), keratosis pilaris May also complain of falling hair

SEBORRHEIC DERMATITIS

1.) No to mild itching; moist plaques with chronic, superficial, inflammatory disease of the skin

Glabella, nasolabial folds, scalp

Pityosporum ovale

Topical antifungals

LESION 2.) Scanty, loose, moist scales and crust 3.) Recurrent slightly erytematous patches and plaques with oily-looking scales 4.) Dry loose whitish/yellowish scales Discrete, round, wellcircumscribed or coin-shaped erythematous edematous, vesicular and crusted patches

AGE OF PREDILECTION

AREA OF PREDILECTION

HALLMARK

ETIOLOGY

PREDISPOSING FACTORS

TREATMENT

OTHER INFO

NUMMULAR ECZEMA

Young adulthood and old age

INFECTIOUS Pruritic, vesicular, pustular, ECZEMATOUS / or crusted dry and scaly AUTOSENSITIZATION eruptions DERMATITIS

Regional clusters of lesions (eg. Legs or trunk) or generalized, scattered, Lower legs (older men), trunks, hands, and fingers (younger females) Develops on area macerated by the discharge from an infected ulcer or sinus

Unknown

Triamcinolone Crude coal tar (refractory) PUVA or UVB 311nm therapy

Recurrent Staphylococcal infection often present

Skin becomes sensitized to bacterial or tissue chemical substances

Diabetics with nonhealing wounds Chronic otitis media, bedsore, fistula; eye, nose, vagina discharge

Oral glucocorticoids

Do antibiotic sensitivity testing to treat underlying cause

LESION CONTACT DERMATITIS A. IRRITANT CONTACT DERMATITIS ACUTE. Erythema with a dull nonglistening surfacevesiculation (or blister formation)erosioncrustin gshedding of crusts and scaling or erythema (chemical burn)necrosisshedding of necrotic tissueulcerationhealing CHRONIC. Drynesschappingerythe mahyperkeratosis and scalingfissures and crusting. Sharp margination gives way to ill-defined borders, lichenification. In irritant reaction ICD also vesicles, pustules, and erosions. Erythematous papules, vesicles, and linear and symmetrical lesions within scratch marks

AGE OF PREDILECTION

AREA OF PREDILECTION Hands

HALLMARK

ETIOLOGY ACUTE. Direct cytotoxic damage to keratinocytes

PREDISPOSING FACTORS

TREATMENT Topical steroids (Betamethasone dipropionate, Clobetasol proprionate)

OTHER INFO Non-allergic inflammatory response No previous exposure necessary

CHRONIC.Slow damage to cell membranes protein denaturation and cellular toxicity

B.

ALLERGIC CONTACT DERMATITIS / DERMATITIS VENENATA

Delayed reaction; cellmediated hypersensitivit y reaction

Topical steroids

With previous sensitization Rubbers, cosmetics, dyes, oil resins, chemicals in fabrics, insecticides, resins, products of bacteria, fungi, parasites 3

LESION C. DIAPER/NAP KIN DERMATITIS Erythematous and papulovesicular dermatitis Superficial erosion in severe cases Tip of penis maybe irritated and crusted

AGE OF PREDILECTION

AREA OF PREDILECTION Lower abdomen, genitals, thighs,convex surfaces of the buttocks

HALLMARK Inguinal and suprapubic folds not involved

ETIOLOGY Alkaline irritative effects of ammonia formed in the wet diaper by the splitting of urea by the ammoniaforming bacillus in the feces

PREDISPOSING FACTORS

TREATMENT Frequent change of diapers Topical Hydrocortisone

OTHER INFO

D.

IRRITANT HAND DERMATITIS /HOUSEWIF ES ECZEMA

Begins with dryness and redness of the fingers Dry scales with peeling are evident at the tips of the fingers, chapping is seen on the back of the hands, and erythematous hardening of the palms and fissures develops. Pruritic, tender Plaque / patch / maceration /erosion erythema

Under rings when not removed while washing

Betamethasone diproprionate Clobetasol proprionate Triamcinolone

INTERTRIGO

Inframammar y regions, axillae, groins, gluteal folds, where skin surfaces are in apposition

Inflammatory reaction caused by friction, heat, moisture

LESION STASIS ECZEMA Blotchy red mottling with yellowish or light brown pigmentation of the Maybe papular, scaly and itching Pruritic erruptionlichenification thick plaques

AGE OF PREDILECTION

AREA OF PREDILECTION lower inner 1/3 of the legs

HALLMARK

ETIOLOGY Chronic Venous Insufficiency

PREDISPOSING FACTORS

TREATMENT

OTHER INFO Swelling maybe noted late in the afternoon and spontaneously relieved in the morning

PHOTOALLERGIC DERMATITIS

Neck, face, forearms, dorsum of hands and sun-exposed areas

2 E. DRY CHRONIC ECZEMA LESION LICHEN SIMPLEX CHRONICUS (NEURODERMATITIS CIRCUMSCRIPTA) Leathery skin patches are excoriated, slightly scaly or moist, and rarely nodular Thickened hyperpigmented plaques with prominent skin markings secondary to constant scratching AGE OF PREDILECTION AREA OF PREDILECTION Nuchal area (female), scalp, ankle, lower legs, upper thighs, exterior forearms, vulva, pubis, anal area, scrotum, groin HALLMARK ETIOLOGY Epidermal hyperplasia Stress and anxiety PREDISPOSING FACTORS TREATMENT Topical steroids Goal: cessation of pruritus OTHER INFO There is a habitual itch-scratch cycle

LESION PRURIGO NODULARIS single or multiple itching nodules with excoriations individual lesions are pea-sized or larger, firm, erythematous, and brownish Uniform time of the primary lesion (dome-shaped papules topped by a vesicle) and by chronicity, severity, scars, lichenification, and eczematization

AGE OF PREDILECTION

AREA OF PREDILECTION Anterior surfaces of thighs and legs

HALLMARK

ETIOLOGY Constant picking and scratching

PREDISPOSING FACTORS

TREATMENT Triamcinolone

OTHER INFO

PRURIGO MITIS

Early childhood

Topical steroids

Symmetricallydistributed

fin/ henshinv3