subject: Eczema/ Dermatitis and its diagnosis and management [print this page] Eczema/ Dermatitis and its diagnosis and management
Exogenous dermatitis
Air-borne contact dermatitis
Photodermatitis
Phytophotodermatitis
Irritant contact dermatitis
Allergic contact dermataitis
Infectious eczematoid dermatitis
Endogenous dermatitis
Atopic dermatitis
Seborrheic dermatitis
Nummular eczema
Stasis dermatitis
Pompholyx
Atopic dermatitis It is a part component of atopic diathesis and is characterized by lowered threshold to pruritus. It may arbitarily be divided into infantile, childhood/ adolescent and adult variants.The face, particularly the cheeks are the usually affected site.
Seborrheic dermatitis It is the part component of seborrheic diathesis which includes acne vulgaris, rosacea, seborrheic dermatitis, and labile personality. The dermatitis is characterized by scaly patches, the margins of which are indistinct.
Nummular dermatitis It presents with characteristic round, nummular, coin like lesions, distributed on the extensor surface of the extremities, posterior aspect of the trunk, buttocks, and lower legs.
Stasis dermatitis It usually affects persons like teachers, laborers, rickshaw-pullers, athletes, etc. whose work requires long hour of standing. This predisposes to varicose veins with tortuous, dilated veins over the legs. It is followed by stasis of blood on the dependent parts of the legs.
Air borne contact dermatitis It is usually encountered in those who work in open and are exposed to dust, pollens, and other particles suspended in the air.
Photodermatitis It is the general name used to define the abnormal eczematous response to the stimulus of light. It is usually evoked in association with chemicals which are innocuous to the skin in absence of light exposure.
DIAGNOSIS The diagnosis of acute eczema is made by the presence of cardinal clinical features of erythema, edema, vesiculation, and crusting, and associated itching. The chronic lichenified dermatitis is characterized by hyperpigmentation, thickening of the skin, and exaggeration of skin markings. The clinical features of respective eczemas (vide supra) should help in forming the diagnosis. Office procedures, namely patch test for contact dermatitis, photopatch test for photodermatitis and exposure withdrawl test for air borne contact dermatitis.
TREATMENT The corticosteroid form the mainstay of treatment. These may be combined with antihistamines. Antibiotics may be indicated in associated secondary infection. Topical bland compresses like potassium permagnate, boric acid or aluminium subacetate are essential.
Herbal Unani Treatment Majoon ushba 10 gm twice daily for 30 days, Majoon chobchini 10 gm twice daily, Decoction musaffi khoon 10 gm an Marham Gulabi for local application.
