Asteatotic Eczema - Causes, Symptoms and Treatment

Asteatotic eczema is eczema occurring secondarily to a very dry skin. Asteatotic eczema of the lower extremities in elderly persons secondary to aging, dehydrated skin, and malnutrition Most commonly found on the lower leg, it is characterized erythema with a fissuring pattern reminiscent of a crackle glaze used in pottery. excess water loss from the epidermis results in dehydration of the stratum corneum with upward curling of corneocytes. The outer keratin layers require 10-20% water concentration to maintain their integrity. A significant 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. Elderly persons with decreased sebaceous and sweat gland activity, patients on antiandrogen therapy, people using 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 shrink. Allergic contact dermatitis and irritant contact dermatitis may cause a persistent and possibly more extensive dermatitis despite therapy. Low environmental humidity contributes to xerosis, creating a clinical picture of asteatotic dermatitis in some dermatologic conditions, such as atopic dermatitis. Most cases resolve 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 dull, with fine scaling. In more advanced 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 pronounced lesions.
Men older than 60 years develop asteatotic dermatitis more commonly than women. The cause asteatotic dermatitis, including is Nutritional deficiencies , Low environmental humidity and cold winds that increase the loss of water by convection , Ichthyosis and Neurologic disorders - Decreased sweating in denervated areas. A significantly decreased cellular volume can stress the skin's elasticity, creating fissures. Edema in the dermis leads to additional stretch on the overlying epidermis. Fissures rupture dermal capillaries, causing clinical bleeding. The disruption of cutaneous integrity can result in inflammation with risk of infection. Transepidermal absorption of allergens and irritants is increased as the epidermis is damaged, increasing susceptibility to allergic contact dermatitis and irritant contact dermatitis. Several treatment options for eczema are available. Avoiding 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.
• Eliminate 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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