The Skin Condition Dermatitis

Symptoms, Diagnosis, and Treatment

Dry skin on the hands.
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Simply put, dermatitis is inflammation of the skin. Based on this definition, almost any rash can be thought of as dermatitis—including psoriasis, skin cancer, and seborrhea. However, not every rash is called dermatitis.

Dermatitis, though common, can be an uncomfortable or embarrassing condition for some people. However, there are many treatments available that will help alleviate or eliminate symptoms.

Appearance and Symptoms

A dermatitis rash is itchy and red, and it may or may not have distinct margins. The specific look of the rash depends on the type of dermatitis present, as well as on the length of time the rash has been on your skin. Acute dermatitis arises suddenly and is characterized by blisters; subacute dermatitis shows scaling and crusting; and chronic dermatitis is indicated by lichenification, or thickened skin, as a result of longterm irritation.

Types of Dermatitis

There are several distinct types of dermatitis that vary by the cause or the cellular mechanism responsible for the rash. One specific type is allergic contact dermatitis. This is a delayed hypersensitivity reaction involving allergens and antibodies. Another form of dermatitis is irritant contact dermatitis caused by exposure to chemicals or detergents. There's also atopic dermatitis, an allergic-type reaction that is accompanied by hay fever, asthma, and very dry skin.

Other types of dermatitis include:

  • Stasis dermatitis: Occurs on the ankles and lower legs of people with venous insufficiency
  • Diaper dermatitis: A type of irritant dermatitis that's caused by extended exposure of the skin to wet diapers
  • Dyshidrotic dermatitis (pompholyx): A type of dermatitis on the hands or feet that is characterized by redness, scaling, and deep blisters
  • Nummular dermatitis: Coin-shaped patches that occur anywhere on the body as a result of dry skin
  • Seborrheic dermatitis (cradle cap): Yellow, greasy scales like dandruff on the scalp and hair-bearing areas of the head, neck, and upper chest
  • Autosensitization dermatitis (Id reaction): An itchy rash that occurs in response to an intense inflammatory process somewhere else on the body, especially a fungal infection
  • Lichen simplex chronicus: A rash that's caused by long-term scratching of an area, producing thickened skin

Diagnosis

Generally, dermatitis is diagnosed based on the history and appearance of the rash. If possible, the exact type of dermatitis is defined, but sometimes it is difficult to tell the difference between the many types of dermatitis. Your doctor may recommend a diagnostic test for contact or atopic dermatitis or a KOH test identifying a fungal infection.

Treatment

Dermatitis is best treated if the type is known. However, some measures can be taken to improve symptoms even if the exact type of dermatitis is not known.

  1. Keep skin as moisturized as possible, since dryness causes cracks in the outer layer of skin (the epidermis), inhibiting the skin's ability to form a natural barrier.
  2. Use topical medications or antihistamines to reduce itching and scratching.
  3. Avoid irritating and drying substances such as perfumes or harsh detergents, and treat other rashes, especially fungal infections, even though they may not seem related.

Topical Steroids

Topical steroids are often used to treat dermatitis. Topical steroids come in different strengths and can have significant side effects. All topical steroids, except hydrocortisone cream, must be prescribed by a health care provider.

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