Asteatotic Eczema - Causes, Symptoms and Treatment

Asteatotic eczema is eczema happening secondarily to a very dry skin. Asteatotic eczema of the lower extremities in elderly persons secondary to aging, dehydrated skin, and malnutrition. Most commonly observed on the lower leg, it is characterized erythema with a fissuring pattern reminiscent of a crackle glaze used in pottery. Excessive water loss from the epidermis results in dehydration of the stratum corneum with upwardly curling of corneocytes. The outer keratin layers need 10-20% water concentration to maintain their integrity. A meaningful decrease in free fatty acids in the stratum corneum is present in people with asteatotic dermatitis. Stratum corneum lipids act as water modulators, and cutaneous loss of these lipids can increase transepidermal water loss to 75 times that of healthy skin. Aged persons with decreased sebaceous and sweat gland activity, patients on antiandrogen therapy, people applying degreasing agents, and people bathing without replacing natural skin emollients lost to bath water are at risk for asteatotic eczema. When the stratum corneum loses water, the cells flinch. Allergic contact dermatitis and irritant contact dermatitis may cause a pertinacious and possibly more extensive dermatitis despite therapy. Low environmental humidity conduces to xerosis, creating a clinical picture of asteatotic dermatitis in some dermatologic conditions, such as atopic dermatitis. Most cases reconcile without ill effects, asteatotic dermatitis can be chronic with relapses frequent during the winter months and during times of low humidity.

Asteatotic eczema in neurologic disorders. The skin is dry and sluggish, with fine scaling. In more precocious stages, a pattern of superficial cracks and fissures of the horny layer presents, possibly accompanied by erythema, oozing and crusting. Mild xerosis is asymptomatic, whereas itching and stinging may be present in more prominent lesions.
Men older than 60 years develop asteatotic dermatitis more commonly than women. The cause asteatotic dermatitis, including is Nutritional deficiencies,lLow environmental humidity and cold winds which maximises the loss of water by convection, Ichthyosis and Neurologic disorders - Decreased sweating in denervated areas. A notably decreased cellular volume can stress the skin's elasticity, creating fissures. Edema in the dermis leads to additional stretch on the overlaying epidermis. Fissures damages dermal capillaries, causing clinical bleeding. The upset of cutaneous integrity can result in inflammation with risk of infection. Transepidermal absorption of allergens and irritants is increased as the epidermis is ruptured, increasing susceptibility to allergic contact dermatitis and irritant contact dermatitis. Various treatment alternatives for eczema are present. Neglecting too frequent hot baths, instead tepid warm baths without soap and containing bath oils followed by use of emollient ointments. Room humidifiers in bedroom may help (keep humidity above 50%).

Causes of Asteatotic Eczema

Common Causes of Asteatotic Eczema

Atopy.
Ichthyosis.
Malignancies.
Nutritional deficiencies
Psychological stress.
Drugs - Antiandrogen therapy and diuretic therapy.
Neurologic disorders - Decreased sweating in denervated areas.

Sign and Symptoms of Asteatotic Eczema

Common Sign and Symptoms of Asteatotic Eczema

Itching sensation.
Reddening of the skin.
Swelling of the affected areas
Blistering.
Crusting.
Loss of hair in effected areas.

Treatment for Asteatotic Eczema

Common Treatment for Asteatotic Eczema

Take short baths with decreased water temperature.
Use mild, non-alkali soaps.
Minimise or reduce the use of soap on the involved areas. Avoid harsh skin cleansers.
Apply petrolatum-based emollients following bathing, and use moisturizing agents liberally.
Apply topical steroid ointments with or without polyethylene occlusion.
Wear appropriate clothing such as cotton clothing (no wool or synthetic fabric).
Don't rub your body dry after washing, rather dab at it with a soft towel.

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