An Overview of Dermatitis

Dry skin on the hands.

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Dermatitis is irritation or inflammation of the skin. There are many types of dermatitis. Some, such as diaper rash, are characterized by itchy red skin on a specific area of the body. Others involve blisters or breakouts that resemble acne. Dandruff is considered a mild form of dermatitis that affects the scalp. Because most types of dermatitis have a distinctive appearance, they often can be diagnosed based on a physical exam, although other testing, such as patch testing to determine if a specific allergen is to blame for dermatitis, sometimes is necessary. Treatment for dermatitis depends on the type and includes measures to relieve dry skin, itching, and other symptoms.

Types

Strictly speaking, almost any rash could be thought of as dermatitis. However, dermatologists generally use this term in reference to several specific skin conditions.

  • Allergic contact dermatitis is a delayed reaction to touching something you're allergic too. Some common allergens are metals such as zinc, latex, and personal care products.
  • Irritant contact dermatitis is a non-allergic reaction to having direct contact with an item or substance that irritates the skin. Harsh cleansers, perfume, and scented soaps or lotions are common causes of irritant contact dermatitis.
  • Atopic dermatitis: A type of eczema caused by an abnormal immune reaction to allergens.
  • Stasis dermatitis results from poor circulation in the ankles and lower legs, causing the skin in these areas to become dry, itchy, scaly, and discolored. Severe statis dermatitis can result in complications such as cracks in the skin oozing sores, or an infection called cellulitis.
  • Diaper dermatitis: More commonly known as diaper rash, this common condition of infancy is characterized by a red rash on a baby's bottom and nearby skin caused by extended exposure to a wet diaper.
  • Dyshidrotic dermatitis (pompholyx) affects the palms, sides of fingers, soles of feet, and the area between the toes. It starts as a rash made up of small, itchy blisters that eventually become scaly spots. Outbreaks tend to recur.
  • Nummular dermatitis: Also known as nummular eczema or discoid eczema, this conditions appears as itchy, coin-shaped patches anywhere on the body. Potential causes include an allergic reaction or an such as a burn or insect bite.
  • Seborrheic dermatitis is characterized by yellow, greasy scales on the scalp and hair-bearing areas of the head, neck, and upper chest. Dandruff is a mild form of seborrheic dermatitis. In babies, this condition is known as infantile seborrheic dermatitis or cradle cap.
  • Autosensitization dermatitis: The itchy, water-filled blisters that characterize this rash develop in response to an intense inflammatory process somewhere else on the body such as a fungal infection. This response is known as an interface dermatitis reaction or ID reaction.
  • Perioral dermatitis can sometimes be mistaken for an acne breakout. It affects the skin around the mouth, nose, or eyes and is brought on by irritation to the skin or an allergic reaction.

Symptoms

Changes in the appearance of the skin are the most obvious symptom of dermatitis. Many types cause a dry, red rash. Others are characterized by more distinct changes such as scaling or flaking, blisters, distinct patches of affected skin, or acne-like breakouts.

Itching is common among most types of dermatitis and can be quite intense and uncomfortable. Scratching can lead to a condition called lichen simplex chronicus, in which frequent scratching causes skin to become thick, leathery, and discolored.

Diagnosis

Determining the specific cause of dermatitis often can be done based on a physical exam and medical history taken by a doctor. Obvious cases can be diagnosed by a general practitioner, while others may need to be assessed by a dermatologist.

Testing sometimes is necessary. For example, to diagnose the cause of dermatitis caused by an allergic reaction, a patch test may be required. This involves placing small amounts of suspected allergens on an unaffected area of skin to see if any bring on an allergic reaction.

A KOH test, in which samples of skin or nails are placed in a solution of potassium hydroxide and examined under a microscope, can identify an underlying fungal infection associated with dermatitis.

Finally, because some types of dermatitis resemble other skin conditions, a practitioner may need to do a differential diagnosis to rule out conditions such as psoriasis or rosacea.

Treatment

Treatment for dermatitis typically focuses on relieving symptoms. Often an over-the-counter hydrocortisone cream can effectively reduce dry skin and itching. For severe dermatitis, a prescription topical steroid may be necessary. An oral antihistamine can ease intense itching.

Some types of dermatitis require specific treatment. For example, a dandruff shampoo may help clear up seborrheic dermatitis. Diaper rash often can be alleviated with more frequent diaper changes and a generous layer of diaper cream to create a barrier between a baby's skin and moisture.

It's also important to avoid allergens or contact with known irritants to prevent reoccurrences of dermatitis.

A Word From VeryWell

Dermatitis is a common skin condition. Though it can be uncomfortable, painful, or embarrassing at times to have an itchy rash on your body, once correctly diagnosed most types of dermatitis can be effectively treated and prevented. This is why it's important to see a doctor or dermatologist about any rash or other skin change you develop. The sooner you start treatment, the sooner your symptoms will subside and your skin will be clear.

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