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Dermatitis

Dermatitis

Definition

Dermatitis is a general term used to describe inflammation of the skin.

Description

Most types of dermatitis are characterized by a pink or red rash that itches.

Contact dermatitis is an allergic reaction to something that irritates the skin and is manifested by one or more lines of red, swollen, blistered skin that may itch or weep. It usually appears within 48 hours after coming into contact with a substance to which the skin is sensitive. The condition is more common in adults than in children.

Contact dermatitis can occur on any part of the body, but it usually affects the hands, feet, and groin. Contact dermatitis usually does not spread from one person to another, nor does it spread beyond the area exposed to the irritant unless affected skin comes into contact with another part of the body. However, in the case of some irritants, such as poison ivy, contact dermatitis can be passed to another person or to another part of the body.

Stasis dermatitis is characterized by scaly, greasy looking skin on the lower legs and around the ankles. Stasis dermatitis is most apt to affect the inner side of the calf.

Nummular dermatitis, which is also called nummular eczematous dermatitis or nummular eczema , generally affects the hands, arms, legs, and buttocks of men and women older than 55 years of age. This stubborn, inflamed rash forms circular, sometimes itchy, patches and is characterized by flares and periods of inactivity.

Atopic dermatitis is characterized by itching , scaling, swelling, and sometimes blistering. In early childhood it is called infantile eczema and is characterized by redness, oozing, and crusting. It is usually found on the face, inside the elbows, and behind the knees.

Seborrheic dermatitis may be dry or moist and is characterized by greasy scales and yellowish crusts on the scalp, eyelids, face, external surfaces of the ears, under-arms, breasts, and groin. In infants it is called cradle cap .

Causes & symptoms

Allergic reactions are genetically determined, and different substances cause contact dermatitis to develop in different people. A reaction to resin produced by poison ivy, poison oak , or poison sumac is the most common source of symptoms. It is, in fact, the most common allergy in this country, affecting one of every two people in the United States.

Flowers, herbs, and vegetables can also affect the skin of some people. Burns and sunburn increase the risk of dermatitis developing, and chemical irritants that can cause the condition include:

  • chlorine
  • cleansers
  • detergents and soaps
  • fabric softeners
  • glues used on artificial nails
  • perfumes
  • topical medications

Contact dermatitis can develop when the first contact occurs or after years of use or exposure.

Stasis dermatitis, a consequence of poor circulation, occurs when leg veins can no longer return blood to the heart as efficiently as they once did. When that happens, fluid collects in the lower legs and causes them to swell. Stasis dermatitis can also result in a rash that can break down into sores known as stasis ulcers.

The cause of nummular dermatitis is not known, but it usually occurs in cold weather and is most common in people who have dry skin. Hot weather and stress can aggravate this condition, as can the following:

  • allergies
  • fabric softeners
  • soaps and detergents
  • wool clothing
  • bathing more than once a day

Atopic dermatitis can be caused by allergies, asthma , or stress, and there seems to be a genetic predisposition for atopic conditions. It is sometimes caused by an allergy to nickel in jewelry.

Seborrheic dermatitis (for which there may also be a genetic predisposition) is usually caused by overproduction of the oil glands. In adults it can be associated with diabetes mellitus or gold allergy. In infants and adults it may be caused by a biotin or vitamin B deficiency.

Diagnosis

The diagnosis of dermatitis is made on the basis of how the rash looks and its location. The doctor may scrape off a small piece of affected skin for microscopic examination or direct the patient to discontinue use of any potential irritant that has recently come into contact with the affected area. Two weeks after the rash disappears, the patient may resume use of the substances, one at a time, until the condition recurs. Eliminating the substance most recently added should eliminate the irritation.

If the origin of the irritation has still not been identified, a dermatologist may perform one or more patch tests. This involves dabbing a small amount of a suspected irritant onto skin on the patient's back. If no irritation develops within a few days, another patch test is performed. The process continues until the patient experiences an allergic reaction at the spot where the irritant was applied.

Treatment

Herbal treatments for dermatitis

Some herbal therapies can be useful for skin conditions. Among the herbs most often recommended are:

  • burdock root (Arctium lappa )
  • calendula (Calendula officinalis ) ointment
  • chamomile (Matricaria recutita ) ointment
  • cleavers (Galium ssp.)
  • evening primrose oil (Oenothera biennis )
  • nettles (Urtica dioica )

Treatments for contact dermatitis

Contact dermatitis can be treated botanically and homeopathically. Specific homeopathic remedies are designed for individuals. Grindelia (Grindelia spp.) and sassafras (Sassafras albidum ) can help when applied topically. Determining the source of the problem and eliminating it is essential. Oatmeal baths are very helpful in relieving the itch. Bentonite clay packs or any mud pack draws the fluid and helps dry up the lesions. Cortisone creams are not recommended by practitioners of natural medicine as they suppress the reaction rather than clear it.

Treatments for atopic dermatitis

NUTRITIONAL THERAPY. Because most cases of atopic dermatitis are caused by food allergy, the following dietary changes are often recommended:

  • Identification and avoidance of allergenic foods. Foods that often cause allergy in infants include milk, eggs, peanuts, tomatoes, seafoods, wheat, and soybean.
  • Supplementing daily diet with vitamin A (5,000 U), vitamin E (400 IU) and zinc (45-60 mg) or alternatively, taking multivitamin-and-mineral supplement one tablet once daily.
  • Taking fish oils supplements. Adults should take 540 mg of EPA and 360 mg of DHA per day.

Additionally, flavonoids such as quercetin, grape-seed extract and green tea extract, and ginkgo biloba may be helpful for some people.

HERBAL THERAPY. The following herbal preparations may be helpful:

  • Glycyrrhiza glabra (licorice)
  • Arctium lappa (burdock, gobo)
  • Taraxacum officinale (dandelion)

Treatments for seborrheic dermatitis

Treatments for this common skin disorder include topical applications and nutritional therapy.

NUTRITIONAL THERAPY. Diet is one of the major causes of seborrheic dermatitis especially in infants. Therefore, the following dietary changes and nutritional supplements are often necessary:

  • Identification and avoidance of foods that may cause allergies. Common allergenic foods in infants are wheat, corn, citrus, peanuts, eggs and seafoods.
  • Eating biotin-rich foods (soy foods, sesame, barley) or taking biotin supplements. Seborrheic dermatitis may be caused by biotin deficiency. Infants often respond well to biotin treatment alone (without vitamin B-complex supplementation).
  • Taking daily multivitamin and mineral supplement which provides high amounts of vitamin B-complex, especially vitamin B6, and zinc. Seborrheic adults often require both vitamin B-complex and biotin supplements.
  • One tablespoon per day (for adults). Flaxseed oil is a good source of omega-3 fatty acids that help moisturize the skin and decrease inflammation.

TOPICAL TREATMENT. Selenium-based shampoos are often used to treat greasy scales and crusts on the scalp. Some adults with seborrheic scales on the scalp, nose, brow around the mouth respond well to topical treatment with pyridoxine (50 mg/g) ointment.

Stasis dermatitis

Stasis dermatitis should be treated by a trained practitioner. This condition responds well to topical herbal therapies, however, the cause must also be addressed.

Allopathic treatment

Treating contact dermatitis begins with eliminating or avoiding the source of irritation. Prescription or over-the-counter corticosteroid creams can lessen inflammation and relieve irritation. Creams, lotions, or ointments not specifically formulated for dermatitis can intensify the irritation. Oral antihistamines are sometimes recommended to alleviate itching, and antibiotics are prescribed if the rash becomes infected. Medications taken by mouth to relieve symptoms of dermatitis can make skin red and scaly and cause hair loss .

Patients who have a history of dermatitis should remove their rings before washing their hands. They should use bath oils or glycerine-based soaps and bathe in lukewarm saltwater.

Patting rather than rubbing the skin after bathing and thoroughly massaging lubricating lotion or nonprescription cortisone creams into still-damp skin can soothe red, weepy nummular dermatitis. Highly concentrated cortisone preparations should not be applied to the face, armpits, groin, or rectal area.

Coal-tar salves can help relieve symptoms of nummular dermatitis that have not responded to other treatments, but these ointments have an unpleasant odor and stain clothing.

Patients who have stasis dermatitis should elevate their legs as often as possible and sleep with a pillow between the lower legs.

Tar or zinc paste may also be used to treat stasis dermatitis. Because these compounds must remain in contact with the rash for as long as two weeks, the paste and bandages must be applied by a nurse or a doctor.

Coal-tar shampoos may be used for seborrheic dermatitis that occurs on the scalp. Sun exposure after the use of these shampoos should be avoided because the risk of sunburn of the scalp is increased.

Expected results

Dermatitis is often chronic, but symptoms can generally be controlled.

Prevention

Contact dermatitis can be prevented by avoiding the source of irritation. If the irritant cannot be avoided completely, the patient should wear gloves and other protective clothing whenever exposure is likely to occur.

Immediately washing the exposed area with soap and water can stem allergic reactions to poison ivy, poison oak, or poison sumac, but because soaps can dry the skin, patients susceptible to dermatitis should use them only on the face, feet, genitals and underarms.

Clothing should be loose fitting and 100% cotton. New clothing should be washed in dye-free, unscented detergent before being worn.

Injury to the lower leg can cause stasis dermatitis to ulcerate (form open sores). If stasis ulcers develop, a doctor should be notified immediately.

Yoga and other relaxation techniques may help prevent atopic dermatitis caused by stress.

Avoidance of sweating may aid in preventing seborrheic dermatitis.

A patient who has dermatitis should also notify a doctor if any of the following occurs:

  • Fever develops
  • Skin oozes or other signs of infection appear
  • Symptoms do not begin to subside after seven days treatment
  • Contact with someone who has a wart, cold sore , or other viral skin infection

Resources

BOOKS

Editors of Time-Life Books. The Medical Advisor: The Complete Guide to Conventional and Alternative Treatments. Alexandria, VA: Time-Life, Inc., 1996.

Gottlieb, B., ed. New Choices in Natural Healing. Emmaus, PA: Rodale Press, Inc., 1995.

Murray, Michael T. and Joseph E. Pizzorno. "Seborrheic Dermatitis." In Encyclopedia of Natural Medicine. Rev. 2nd ed. Rocklin, CA: Prima Publishing, 1998.

Murray, Michael T. and Joseph E. Pizzorno. "Eczema (Atopic Dermatitis)." Encyclopedia of Natural Medicine. Rev. 2nd ed. Rocklin, CA: Prima Publishing, 1998.

OTHER

Allergic Contact Dermatitis. http://www.skinsite.com/info_allergic.htm. (10 April 1998).

Dermatitis, Contact. http://www.thriveonline.com.health/Library/illsymp/illness162.html. (10 April 1998).

Nummular Dermatitis. http://www.skinsite.com/info_nummular_dermatitis.htm. (7 April 1998).

Poison ivy, oak, sumac. http://www.thriveonline.com/health/Library/illsymp/illness413.html. (10 April 1998).

Stasis Dermatitis. http://www.skinsite.com/info_stasis_dermatitis.htm. (7 April 1998).

Mai Tran

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Dermatitis

Dermatitis

Definition

Dermatitis is a general term used to describe inflammation of the skin.

Description

Most types of dermatitis are characterized by an itchy pink or red rash.

Contact dermatitis is an allergic reaction to something that irritates the skin and is manifested by one or more lines of red, swollen, blistered skin that may itch or seep. It usually appears within 48 hours after touching or brushing against a substance to which the skin is sensitive. The condition is more common in adults than in children.

Contact dermatitis can occur on any part of the body, but it usually affects the hands, feet, and groin. Contact dermatitis usually does not spread from one person to another, nor does it spread beyond the area exposed to the irritant unless affected skin comes into contact with another part of the body. However, in the case of some irritants, such as poison ivy , contact dermatitis can be passed to another person or to another part of the body.

Atopic dermatitis is characterized by itching , scaling, swelling, and sometimes blistering. In early childhood it is called infantile eczema and is characterized by redness, oozing, and crusting. It is usually found on the face, inside the elbows, and behind the knees.

Seborrheic dermatitis may be dry or moist and is characterized by greasy scales and yellowish crusts on the scalp, eyelids, face, external surfaces of the ears, underarms, breasts, and groin. In infants it is called cradle cap.

Demographics

Allergic reactions are common. No formal statistics are kept on such attacks.

Causes and symptoms

Allergic reactions are genetically determined, and different substances cause contact dermatitis to develop in different people. A reaction to resin produced by poison ivy, poison oak , or poison sumac is the most common source of symptoms. It is, in fact, the most common allergy in the United States, affecting one of every two people in the country.

Flowers, herbs, and vegetables can also affect the skin of some people. Burns and sunburn increase the risk of dermatitis developing. Chemical irritants that can cause the condition include:

  • chlorine
  • cleansers
  • detergents and soaps
  • fabric softeners
  • glues used on artificial nails
  • perfumes
  • topical medications

Contact dermatitis can develop when the first contact occurs or after years of use or exposure.

Atopic dermatitis can be caused by allergies , asthma , or stress, and there seems to be a genetic predisposition for atopic conditions. It is sometimes caused by an allergy to nickel in jewelry.

Seborrheic dermatitis (for which there may also be a genetic predisposition) is usually caused by overproduction of the oil glands. In adults it can be associated with diabetes mellitus or gold allergy. In infants and adults it may be caused by a biotin deficiency.

When to call the doctor

A doctor or other healthcare provider should be consulted when rashes appear. With some experience, common rashes can be accurately identified by parents. Rashes that cannot be accurately identified should be referred to competent healthcare professional for identification and possible treatment.

Diagnosis

The diagnosis of dermatitis is made on the basis of how the rash looks and its location. The doctor may scrape off a small piece of affected skin for microscopic examination or direct the person to discontinue use of any potential irritant that has recently come into contact with the affected area. Two weeks after the rash disappears, the person may resume use of the substances, one at a time, until the condition recurs. Eliminating the substance most recently added should eliminate the irritation.

If the origin of the irritation has still not been identified, a dermatologist may perform one or more patch tests, which involves dabbing a small amount of a suspected irritant onto skin on the person's back. If no irritation develops within a few days, another patch test is performed. The process continues until the person experiences an allergic reaction at the spot where the irritant was applied.

Treatment

Treating contact dermatitis begins with eliminating or avoiding the source of irritation. Prescription or over-the-counter corticosteroid creams can lessen inflammation and relieve irritation. Creams, lotions, or ointments not specifically formulated for dermatitis can intensify the irritation. Oral antihistamines are sometimes recommended to alleviate itching, and antibiotics are prescribed if the rash becomes infected. Medications taken by mouth to relieve symptoms of dermatitis can make skin red and scaly and cause hair loss.

People who have a history of dermatitis should remove their rings before washing their hands. They should use bath oils or glycerin-based soaps and bathe in lukewarm saltwater.

Patting rather than rubbing the skin after bathing and thoroughly massaging lubricating lotion or nonprescription cortisone creams into still-damp skin can soothe red, irritated nummular dermatitis. Highly concentrated cortisone preparations should not be applied to the face, armpits, groin, or rectal area. Periodic medical monitoring is necessary to detect side effects in people who use such preparations on rashes covering large areas of the body.

Coal-tar salves can help relieve symptoms of nummular dermatitis that have not responded to other treatments, but these ointments have an unpleasant odor and stain clothing.

Coal-tar shampoos may be used for seborrheic dermatitis that occurs on the scalp. Sun exposure after the use of these shampoos should be avoided because the risk of sunburn of the scalp is increased.

Alternative treatment

Some herbal therapies can be useful for skin conditions. Among the herbs most often recommended are:

  • burdock root (Arctium lappa )
  • calendula (Calendula officinalis ) ointment
  • chamomile (Matricaria recutita ) ointment
  • cleavers (Galium ssp.)
  • evening primrose oil (Oenothera biennis )
  • nettles (Urtica dioica )

Contact dermatitis can be treated botanically and homeopathically. Grindelia (Grindelia spp.) and sassafras (Sassafras albidum ) can help when applied topically. Determining the source of the problem and eliminating it is essential. Oatmeal baths are very helpful in relieving the itch. Bentonite clay packs or any mud-pack draws the fluid out and helps dry up the lesions. Cortisone creams are not recommended.

Selenium-based shampoos, topical applications of flax oil and/or olive oil, and biotin supplementation are among the therapies recommended for seborrheic dermatitis.

Prognosis

Dermatitis is often chronic, but symptoms can generally be controlled.

Prevention

Contact dermatitis can be prevented by avoiding the source of irritation. If the irritant cannot be avoided completely, the person should wear gloves and other protective clothing whenever exposure is likely to occur.

Immediately washing the exposed area with soap and water can stem allergic reactions to poison ivy, poison oak, or poison sumac, but because soaps can dry the skin, people susceptible to dermatitis should use them only on the face, feet, genitals, and underarms.

Clothing should be loose fitting and 100 percent cotton. New clothing should be washed in dye-free, unscented detergent before being worn.

Yoga and other relaxation techniques may help prevent atopic dermatitis caused by stress.

Avoidance of sweating may aid in preventing seborrheic dermatitis.

A person who has dermatitis should also notify a doctor if any of the following occurs:

  • fever develops
  • skin oozes or other signs of infection appear
  • symptoms do not begin to subside after seven days of treatment
  • he/she comes into contact with someone who has a wart, cold sore , or other viral skin infection

KEY TERMS

Allergic reaction An immune system reaction to a substance in the environment; symptoms include rash, inflammation, sneezing, itchy watery eyes, and runny nose.

Corticosteroids A group of hormones produced naturally by the adrenal gland or manufactured synthetically. They are often used to treat inflammation. Examples include cortisone and prednisone.

Patch test A skin test in which different antigens (substances that cause an allergic reaction) are introduced into a patient's skin via a needle prick or scratch and then observed for evidence of an allergic reaction to one or more of them. Also known as a scratch test.

Rash A spotted, pink or red skin eruption that may be accompanied by itching and is caused by disease, contact with an allergen, food ingestion, or drug reaction.

Ulcer A site of damage to the skin or mucous membrane that is characterized by the formation of pus, death of tissue, and is frequently accompanied by an inflammatory reaction.

Nutritional concerns

Eating a balanced and adequate diet is generally helpful. People who are susceptible to dermatitis that is linked to particular foods obviously should avoid consuming them.

Parental concerns

Parents should try to monitor new substances and foods when their children encounter them for the first time.

Resources

BOOKS

Bolognia, Jean L., and Irwin M. Braverman. "Skin Manifestations of Internal Disease." In Harrison's Principles of Internal Medicine, 15th ed. Edited by Eugene Braunwald et al. New York: McGraw-Hill, 2001, pp. 31530.

Darmstadt, Gary L., and Robert Sidbury. "Diseases of the Dermis." In Nelson Textbook of Pediatrics, 17th ed. Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2003, pp. 22049.

. "Eczematous Disorders." In Nelson Textbook of Pediatrics, 17th ed. Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2003, pp. 218890.

. "Nutritional Dermatoses." In Nelson Textbook of Pediatrics, 17th ed. Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2003, pp. 224850.

Lim, Henry M. "Eczemas, Photodermatoses, Papulosquamous (including Fungal) Diseases, and Figurate Erythemas." In Cecil Textbook of Medicine, 22nd ed. Edited by Lee Goldman et al. Philadelphia: Saunders, 2003, pp. 245865.

Swerlick, Robert A., and Thomas J. Lawley. "Eczema, Psoriasis, Cutaneous Infections, Acne, and Other Common Skin Disorders." In Harrison's Principles of Internal Medicine, 15th ed. Edited by Eugene Braunwald et al. New York: McGraw-Hill, 2001, pp. 30914.

PERIODICALS

Capon, F., et al. "An update on the genetics of psoriasis." Dermatologic Clinics 22, no. 4 (2004): 33947.

Johnson, S. M., et al. "Topical treatment for atopic dermatitis in the 21st century." Journal of Arkansas Medical Society 101, no. 3 (2004): 8690.

Smith, A. "Contact dermatitis: diagnosis and management." British Journal of Community Nursing 9, no. 9 (2004): 36571.

Ward, S. "The effective management of atopic dermatitis in school-age children." Nursing Times 100, no. 32 (2004): 556.

ORGANIZATIONS

American Academy of Dermatology. 930 N. Meacham Road, PO Box 4014, Schaumburg, IL 601684014. Web site: <www.aad.org/>.

WEB SITES

"Atopic Dermatitis." National Institute of Arthritis and Musculoskeletal and Skin Diseases, April 2003. Available online at <www.niams.nih.gov/hi/topics/dermatitis/> (accessed January 5, 2005).

"Atopic Dermatitis (Atopic Eczema)." National Jewish Research and Medical Center. Available online at <www.nationaljewish.org/medfacts/atopic.html> (accessed January 5, 2005).

"Dermatitis." MedlinePlus. Available online at <www.nlm.nih.gov/medlineplus/dermatitis.html> (accessed January 5, 2005).

"Eczema (Atopic Dermatitis)." MedlinePlus. Available online at <www.nlm.nih.gov/medlineplus/ency/article/000853.htm (accessed January 5, 2005).

Seborrheic Dermatitis." American Academy of Family Practice, April 2004. Available online at <http://familydoctor.org/157.xml> (accessed January 5, 2005).

L. Fleming Fallon, Jr., MD, DrPH

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Fallon, L.. "Dermatitis." Gale Encyclopedia of Children's Health: Infancy through Adolescence. 2006. Encyclopedia.com. 25 Sep. 2016 <http://www.encyclopedia.com>.

Fallon, L.. "Dermatitis." Gale Encyclopedia of Children's Health: Infancy through Adolescence. 2006. Encyclopedia.com. (September 25, 2016). http://www.encyclopedia.com/doc/1G2-3447200185.html

Fallon, L.. "Dermatitis." Gale Encyclopedia of Children's Health: Infancy through Adolescence. 2006. Retrieved September 25, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1G2-3447200185.html

Dermatitis

Dermatitis

Definition

Dermatitis is a general term used to describe inflammation of the skin.

Description

Most types of dermatitis are characterized by an itchy pink or red rash.

Contact dermatitis is an allergic reaction to something that irritates the skin and is manifested by one or more lines of red, swollen, blistered skin that may itch or seep. It usually appears within 48 hours after touching or brushing against a substance to which the skin is sensitive. The condition is more common in adults than in children.

Contact dermatitis can occur on any part of the body, but it usually affects the hands, feet, and groin. Contact dermatitis usually does not spread from one person to another, nor does it spread beyond the area exposed to the irritant unless affected skin comes into contact with another part of the body. However, in the case of some irritants, such as poison ivy, contact dermatitis can be passed to another person or to another part of the body.

Stasis dermatitis is characterized by scaly, greasy looking skin on the lower legs and around the ankles. Stasis dermatitis is most apt to affect the inner side of the calf.

Nummular dermatitis, which is also called nummular eczematous dermatitis or nummular eczema, generally affects the hands, arms, legs, and buttocks of men and women older than 55 years of age. This stubborn inflamed rash forms circular, sometimes itchy, patches and is characterized by flares and periods of inactivity.

Atopic dermatitis is characterized by itching, scaling, swelling, and sometimes blistering. In early childhood it is called infantile eczema and is characterized by redness, oozing, and crusting. It is usually found on the face, inside the elbows, and behind the knees.

Seborrheic dermatitis may be dry or moist and is characterized by greasy scales and yellowish crusts on the scalp, eyelids, face, external surfaces of the ears, underarms, breasts, and groin. In infants it is called "cradle cap."

Causes and symptoms

Allergic reactions are genetically determined, and different substances cause contact dermatitis to develop in different people. A reaction to resin produced by poison ivy, poison oak, or poison sumac is the most common source of symptoms. It is, in fact, the most common allergy in this country, affecting one of every two people in the United States.

Flowers, herbs, and vegetables can also affect the skin of some people. Burns and sunburn increase the risk of dermatitis developing, and chemical irritants that can cause the condition include:

  • chlorine
  • cleansers
  • detergents and soaps
  • fabric softeners
  • glues used on artificial nails
  • perfumes
  • topical medications

Contact dermatitis can develop when the first contact occurs or after years of use or exposure.

Stasis dermatitis, a consequence of poor circulation, occurs when leg veins can no longer return blood to the heart as efficiently as they once did. When that happens, fluid collects in the lower legs and causes them to swell. Stasis dermatitis can also result in a rash that can break down into sores known as stasis ulcers.

The cause of nummular dermatitis is not known, but it usually occurs in cold weather and is most common in people who have dry skin. Hot weather and stress can aggravate this condition, as can the following:

  • allergies
  • fabric softeners
  • soaps and detergents
  • wool clothing
  • bathing more than once a day

Atopic dermatitis can be caused by allergies, asthma, or stress, and there seems to be a genetic predisposition for atopic conditions. It is sometimes caused by an allergy to nickel in jewelry.

Seborrheic dermatitis (for which there may also be a genetic predisposition) is usually caused by overproduction of the oil glands. In adults it can be associated with diabetes mellitus or gold allergy. In infants and adults it may be caused by a biotin deficiency.

Diagnosis

The diagnosis of dermatitis is made on the basis of how the rash looks and its location. The doctor may scrape off a small piece of affected skin for microscopic examination or direct the patient to discontinue use of any potential irritant that has recently come into contact with the affected area. Two weeks after the rash disappears, the patient may resume use of the substances, one at a time, until the condition recurs. Eliminating the substance most recently added should eliminate the irritation.

If the origin of the irritation has still not been identified, a dermatologist may perform one or more patch tests. This involves dabbing a small amount of a suspected irritant onto skin on the patient's back. If no irritation develops within a few days, another patch test is performed. The process continues until the patient experiences an allergic reaction at the spot where the irritant was applied.

Treatment

Treating contact dermatitis begins with eliminating or avoiding the source of irritation. Prescription or over-the-counter corticosteroid creams can lessen inflammation and relieve irritation. Creams, lotions, or ointments not specifically formulated for dermatitis can intensify the irritation. Oral antihistamines are sometimes recommended to alleviate itching, and antibiotics are prescribed if the rash becomes infected. Medications taken by mouth to relieve symptoms of dermatitis can make skin red and scaly and cause hair loss.

Patients who have a history of dermatitis should remove their rings before washing their hands. They should use bath oils or glycerine-based soaps and bathe in lukewarm saltwater.

Patting rather than rubbing the skin after bathing and thoroughly massaging lubricating lotion or nonprescription cortisone creams into still-damp skin can soothe red, irritated nummular dermatitis. Highly concentrated cortisone preparations should not be applied to the face, armpits, groin, or rectal area. Periodic medical monitoring is necessary to detect side effects in patients who use such preparations on rashes covering large areas of the body.

Coal-tar salves can help relieve symptoms of nummular dermatitis that have not responded to other treatments, but these ointments have an unpleasant odor and stain clothing.

Patients who have stasis dermatitis should elevate their legs as often as possible and sleep with a pillow between the lower legs.

Tar or zinc paste may also be used to treat stasis dermatitis. Because these compounds must remain in contact with the rash for as long as two weeks, the paste and bandages must be applied by a nurse or a doctor.

Coal-tar shampoos may be used for seborrheic dermatitis that occurs on the scalp. Sun exposure after the use of these shampoos should be avoided because the risk of sunburn of the scalp is increased.

Alternative treatment

Some herbal therapies can be useful for skin conditions. Among the herbs most often recommended are:

  • Burdock root (Arctium lappa )
  • Calendula (Calendula officinalis ) ointment
  • Chamomile (Matricaria recutita ) ointment
  • Cleavers (Galium ssp.)
  • Evening primrose oil (Oenothera biennis )
  • Nettles (Urtica dioica )

Contact dermatitis can be treated botanically and homeopathically. Grindelia (Grindelia spp.) and sassafras (Sassafras albidum ) can help when applied topically. Determining the source of the problem and eliminating it is essential. Oatmeal baths are very helpful in relieving the itch. Bentonite clay packs or any mud pack draws the fluid out and helps dry up the lesions. Cortisone creams are not recommended.

Stasis dermatitis should be treated by a trained practitioner. This condition responds well to topical herbal therapies, however, the cause must also be addressed. Selenium-based shampoos, topical applications of flax oil and/or olive oil, and biotin supplementation are among the therapies recommended for seborrheic dermatitis.

Prognosis

Dermatitis is often chronic, but symptoms can generally be controlled.

Prevention

Contact dermatitis can be prevented by avoiding the source of irritation. If the irritant cannot be avoided completely, the patient should wear gloves and other protective clothing whenever exposure is likely to occur.

Immediately washing the exposed area with soap and water can stem allergic reactions to poison ivy, poison oak, or poison sumac, but because soaps can dry the skin, patients susceptible to dermatitis should use them only on the face, feet, genitals, and underarms.

Clothing should be loose fitting and 100% cotton. New clothing should be washed in dye-free, unscented detergent before being worn.

Injury to the lower leg can cause stasis dermatitis to ulcerate (form open sores). If stasis ulcers develop, a doctor should be notified immediately.

Yoga and other relaxation techniques may help prevent atopic dermatitis caused by stress.

Avoidance of sweating may aid in preventing seborrheic dermatitis.

A patient who has dermatitis should also notify a doctor if any of the following occurs:

  • fever develops
  • skin oozes or other signs of infection appear
  • symptoms do not begin to subside after seven days' treatment
  • he/she comes into contact with someone who has a wart, cold sore, or other viral skin infection

Resources

OTHER

"Allergic Contact Dermatitis." The Skin Site. April 10, 1998 (January 11, 2006). http://www.skinsite.com/info_allergic.htm.

KEY TERMS

Allergic reaction An inappropriate or exaggerated genetically determined reaction to a chemical that occurs only on the second or subsequent exposures to the offending agent, after the first contact has sensitized the body.

Corticosteriod A group of synthetic hormones that are used to prevent or reduce inflammation. Toxic effects may result from rapid withdrawal after prolonged use or from continued use of large doses.

Patch test A skin test that is done to identify allergens. A suspected substance is applied to the skin. After 24-48 hours, if the area is red and swollen, the test is positive for that substance. If no reaction occurs, another substance is applied. This is continued until the patient experiences an allergic reaction where the irritant was applied to the skin.

Rash A spotted, pink or red skin eruption that may be accompanied by itching and is caused by disease, contact with an allergen, food ingestion, or drug reaction.

Ulcer An open sore on the skin, resulting from tissue destruction, that is usually accompanied by redness, pain, or infection.

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Haggerty, Maureen. "Dermatitis." Gale Encyclopedia of Medicine, 3rd ed.. 2006. Encyclopedia.com. 25 Sep. 2016 <http://www.encyclopedia.com>.

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Haggerty, Maureen. "Dermatitis." Gale Encyclopedia of Medicine, 3rd ed.. 2006. Retrieved September 25, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1G2-3451600499.html

dermatitis

dermatitis (der-mă-ty-tis) n. an inflammatory condition of the skin, especially one in which outside agents play a primary role (compare eczema). allergic contact d. dermatitis in which skin changes resembling those of eczema develop as a delayed reaction to contact with a particular allergen. The commonest example in women is nickel d. from jewellery, jean studs, etc.; in men chromium d. is relatively common (cement is the usual source). d. herpetiformis an uncommon very itchy rash with symmetrical blistering, especially on the knees, elbows, buttocks, and shoulders. It is associated with gluten sensitivity. primary irritant d. a condition that may occur in anyone who has sufficient contact with such irritants as acids, alkalis, solvents, and (especially) detergents. It is the commonest cause of occupational d. in hairdressers, nurses, cooks, etc. See also napkin rash. seborrhoeic d. see (seborrhoeic) eczema.

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"dermatitis." A Dictionary of Nursing. 2008. Encyclopedia.com. 25 Sep. 2016 <http://www.encyclopedia.com>.

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dermatitis

dermatitis (dûr´mətī´tĬs), nonspecific irritation of the skin. The causative agent may be a bacterium, fungus, or parasite; it can also be a foreign substance, known as an allergen. Contact dermatitis is an allergic reaction to a substance that comes in contact with the skin, such as soap. Atopic dermatitis, also known as eczema, is a chronic, itching inflammation that tends to run in families susceptible to asthma and hay fever. Stasis dermatitis, or eczema of the legs, is caused by poor circulation and is found in older persons suffering from vascular disorders. When dermatitis is chronic it tends to cause thickening, pigmentation, and scaling, and when acute, a red, itching area of blisters and oozing.

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"dermatitis." The Columbia Encyclopedia, 6th ed.. 2016. Encyclopedia.com. 25 Sep. 2016 <http://www.encyclopedia.com>.

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dermatitis

der·ma·ti·tis / ˌdərməˈtītis/ • n. a condition of the skin in which it becomes red, swollen, and sore, sometimes with small blisters, resulting from direct irritation of the skin by an external agent or an allergic reaction to it. Compare with eczema.

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"dermatitis." The Oxford Pocket Dictionary of Current English. 2009. Encyclopedia.com. 25 Sep. 2016 <http://www.encyclopedia.com>.

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dermatitis

dermatitis A lesion or inflammation of the skin; many nutritional deficiency diseases include more or less specific skin lesions (e.g. ariboflavinosis, kwashiorkor, pellagra, scurvy), but most cases of dermatitis are not associated with nutritional deficiency, and do not respond to nutritional supplements.

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DAVID A. BENDER. "dermatitis." A Dictionary of Food and Nutrition. 2005. Encyclopedia.com. 25 Sep. 2016 <http://www.encyclopedia.com>.

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DAVID A. BENDER. "dermatitis." A Dictionary of Food and Nutrition. 2005. Retrieved September 25, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1O39-dermatitis.html

dermatitis

dermatitis Inflammation of the skin. In acute form, it produces itching and blisters. In chronic form, it causes thickening, scaling and darkening of the skin. See also eczema

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