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Other types of endogenous eczema/dermatitis (2. Venous eczema…
Other types of
endogenous
eczema/dermatitis
1. Seberrhoeic
eczema
Diagnosis
History
PC/HPC: itchy rash, distinctive site
PMH: eczema, asthma, hayfever
DH: current meds, allergies
FH: atopy, skin disease
SH: occupation (exposure), smoking, alcohol, pets
Examination
Erythematous, scaly/flaky, poorly defined, distinctive sites
May have excoriations and lichenification (chronic)
Clinical presentation
Erythematous, scaling, poorly defined
Dstinctive sites - side of nose, forehead, eyes, scalp, behind ears, front of chest, groin, axillae, genitals
Management
Medical
Per atopic eczema
Use steroids with anti-yeast component
(e.g. dactacort - hydrocortisone plus miconazole)
Conservative
Per atopic eczema
Epidemiology
YAs
M>F
HIV patients
2. Venous
eczema
Clinical presentation
Erythematous rash, atrophy blanche (scarring)
Leg ulcers (persistent)
Haemaciderin deposits
Diagnosis
History
PC/HPC: itchy dry skin on legs, ulcers
PMH: varicose veins, DVT
DH: meds, allergies
FH: varicose eczema, varicose veins
SH: smoking, alcohol, exercise, diet
Examination
Symmetrical erythematous scaly patches on lower limbs
May have haemaciderin deposits, venous ulcers
Pathophysiology
Poor valves lead to poor venous drainage, venous
HTN, stasis and oedema
Oedema in skin causes red eczematous response
Exacerbated by other vein pathology (varicose veins, DVT)
Management
Conservative
Per atopic eczema
Medical
Per atopic eczema
Epidemiology
Elderly patients
3. Pompholyx
eczema
Diagnosis
History
PC/HPC: acute onset, hands and feet, itchy, blisters
PMH: eczema, skin disorders
DH: meds, allergies
FH: eczema, other skin disease
SH: smoking, alcohol, diet, occupation
Examination
Scaly, erythematous patches with blisters
Hands and feet only
Clinical presentation
Acute itching and blisters
Hands and feet only
Management
Conservative
Per atopic eczema
Medical
Per atopic eczema
Pathophysiology
Can be atopic or non-atopic
Commoner in summer
4. Asteototic
eczema
Clinical presentation
Dry flaky skin, slightly erythematous
Lower limbs commonly
Diagnosis
History
PC/HPC: chronic, elderly patient, dry skin
PMH: eczema, other skin disorders
DH: meds, allergies
FH: eczema, other skin disease
SH: diet, smoking, alcohol, exercise
Examination
Dry, flaky skin on legs
Slight erythema
Pathophysiology
Drying skin with age
Epidemiology
Elderly
Management
Conservative
Per atopic eczema
Medical
Per atopic eczema
