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  Atopic eczema, irritant dermatitis and contact dermatitis


The skin problem of dermatitis has become a major public health issue in the last two decades. Its proliferation has been attributed to the lifestyle and environmental changes that have occurred with industrialization. Often we are simply unaware of certain contributing factors around us, for instance the lack of exposure to microorganisms at an early age in the highly insulated homes we live in, increasing pollution, workplace exposure to allergens etc.

Since most forms of dermatitis are associated with contact with offending agents, it is very important to know more about them. Moreover, dermatitis occurs in various forms that also need to be distinguished for proper detection and treatment. Though the two major forms of dermatitis are allergic contact dermatitis and irritant contact dermatitis, there are other types too. This section of the website catalogues the other forms of dermatitis.

Dermatitis herpetiformis

The first of the kind is dermatitis herpetiformis, which is a very itchy and blistering skin disease. It is an autoimmune (response of an antibody to naturally present matter in the human body) and polymorphic (occurring in different forms) disease.

It is characterised by granular IgA precipitates present at the tips of the papillary dermis in the skin. Apart from the itchiness, its other symptoms include reddening of the skin, plaques, papules, seropapules, vesicles, digital purpura and excoriations. Moreover, the blisters are usually small. It mainly occurs on the elbows, knees and buttocks. It has an unpredictable progression and decreases and reoccurs unexpectedly. It reduces with rigorous and long-term avoidance of gluten in the diet. It has been associated with a dormant type of celiac disease, autoimmune thyroid disease, and iodine sensitivity. The management of the condition shows reduction with ultrviolet action and dapsone therapy.

Psychological dermatitis

The next kind of dermatitis is psychological dermatitis. Information about psychological dermatitis is vital since it is associated with the interdependence of our mental and physical wellbeing. The relationship of our mind and our skin condition occurs in two forms. Firstly, when a skin problem has psychological implications and secondly when an existing mental distress causes a skin condition. The various skin problems associated with our state of mind, can be grouped according to the role our psychology plays in their development. The article on psychological dermatitis deals with its various types, clinical features and treatment methods. This is very important, since psychological dermatitis must be diagnosed correctly in association with its corresponding mental problem. Moreover, it also often involves psychiatric and psychological treatment as well.

Seborrheic dermatitis

Seborrheic dermatitis is another form that occurs as red, peeling, oily skin eruptions. It mainly occurs on the scalp, nasolabial creases, eyebrows, ears, chest and flexural body areas. Seborrheic dermatitis develops in 1% to 3% of adults and it is more common among men during the time of puberty. It generally occurs more in people over middle age as well. It is has a high incidence among AIDS patients. Malassezia yeasts have a role to play in its development and there is a theory (though debated) that dandruff is a mild non-inflammatory form this disease. Seborrheic dermatitis can occur in combination with other skin conditions such as rosacea, blepharitis or ocular irritation, and acne vulgaris. Treatment methods include keratolytic agents, corticosteroids, and the latest trend of antifungal agents. The details of all this can be found in the relevant article.

Cercarial dermatitis (swimmer's itch)

Cercarial dermatitis (swimmer's itch) is an itchy inflammatory sensitivity to non-human Schistosoma parasites that enter the skin. Generally, skin contact with infected water in ponds, lakes or other water bodies leads to the disease. It is also known by the names of clam digger's itch and sedge pool itch. It is very important to know how to avoid its incidence especially for people who have regular exposure to water bodies. The article on cercarial dermatitis outlines its prevalence, diagnosis, clinical features, pathology, causes and treatment.

Photodermatitis (actinic dermatitis)

Another common form of dermatitis that has been included in this website is chronic actinic dermatitis, also known as photodermatitis. It occurs due to photosensitivity to ultraviolet (UV) and often evident radiation as well. It is more prevalent in patients with a history of allergic contact dermatitis or endogenous (generally atopic or seborrheic) dermatitis. It generally occurs in sun-bathed body location, but other body parts cannot be totally ruled out either. It is very common in Europe, North America and Singapore.

Dermatitis in the elderly

Dermatitis in the elderly has been given special emphasis in this section, since managing dermatitis in the aged is a matter of concern for the medical community. This is mainly because the aged fail to follow a proper skin care regime, which is often the cause of both physically and mentally disturbing dermatitis. The elderly should be made aware that their ageing skin is more vulnerable to diseases and how they should take care of it. The first step to creating awareness is to know about the skin conditions and factors that lead to dermatitis in the elderly. Medical staff such as nurses should also be trained on how to deal with aged dermatitis patients.