Understanding Dermatitis: Types, Symptoms, and Treatment

Dermatitis overview

Dermatitis is the inflammation or irritation of the skin. The skin is the largest organ of the body. It is made up of:

  1. The epidermis: is the outer layer of the skin and contains melanocytes. Melanocytes are melanin-producing cells responsible for our skin color. 
  2. The dermis is the second layer and contains hair follicles and sweat glands.
  3. The hypodermis (subcutaneous tissue) is the innermost layer and is made up of fat and connective tissue.

Dermatitis covers a group of skin diseases that irritate the skin and manifest as different types of rashes, itchiness, and skin changes. 

What are the different types of dermatitis?

There are several types of dermatitis, some of which are atopic dermatitis, contact dermatitis, seborrheic dermatitis, diaper rash, stasis dermatitis, dermatitis herpetiformis, and dyshidrosis. 

Atopic dermatitis

Atopic dermatitis, likewise known as atopic eczema, is a long term chronic inflammation of the skin that starts from childhood. It is usually accompanied by hay fever or asthma. The cause is unknown, but the risk of suffering from atopic dermatitis increases:

  • if a person lives in a dry climate
  • Have a family member with atopic dermatitis
  • Have a family history of allergic disease
  • Suffers from celiac disease

Signs and Symptoms of Atopic dermatitis include: 

  • Red or brownish itchy patches on the face in infants, on the pressure points in children such as the elbows and wrist and mainly on the hands in teenagers
  • Change of pattern of rash as a patient grows older.
  • Crusty bumps on the skin that contains a clear fluid
  • Dry, cracked, scaly skin
  • Swollen, thickened patches of skin
  • Periorbital pigmentation

Diagnosis of atopic dermatitis

Diagnosis is made with the presence of risk factors and physical findings of skin. The UK revised criteria for the diagnosis of atopic dermatitis states that a patient must have itching as a constant complaint and 3 or more of the following factors:

  1. History of flexural dermatitis (front of elbows, back of knees, front of ankles, neck, around the eyes) or involvement of cheeks and/or extensor surfaces in children aged > 18 months.
  2. Visible flexural dermatitis involving the skin creases or the cheeks and/or extensor surfaces in children aged > 18months.
  3. History of dry skin in the past year
  4. History of asthma or hay fever or atopic disease in a first degree relative in children < 4 years of age
  5. Onset before 2years of age (this is only for children aged > 4years at the time of diagnosis).

How do you cure atopic dermatitis?

The treatment of atopic dermatitis are as follows:

  • Use of hydrating moisturizing creams.
  • Topical steroids
  • Vitamin D supplements.
  • Probiotics
  • Immunosuppressants: Ciclosporin, Methotrexate and Mycophenolate mofetil
  • Crisaborole (is a nonsteroidal topical medication).
  • Dupilumab
  • Antihistamines (Loratadine and chlorpheniramine).
  • Use of humidifiers in the home and living environments.

Contact dermatitis 

Contact dermatitis is inflammation of the skin that occurs as a result of contact with a foreign object. There are 3 types of contact dermatitis: 

  • Allergic contact dermatitis: is a response to an allergen. The most common allergens are formaldehyde, balsam of Peru, chromium, cobalt chloride, neomycin, nickel, poison ivy, and fragrance mix. 
  • Irritant contact dermatitis: is a skin reaction to chemical irritants or physical irritants (things that irritate the skin). Examples of irritants that can cause contact dermatitis are ethylene oxide, kerosene, printing inks, spices, and perfume.
  • Phototoxic contact dermatitis: is the presence of skin reaction when the allergen or irritant of this type of dermatitis is triggered by sunlight.

Signs and Symptoms of Contact Dermatitis:

  • Presence of multiple confluence of rashes (patches, vesicles, and blisters) on the area of contact with an irritant or allergen That is red, itchy, and filled with fluid
  • Fluid-filled rashes that ooze and crust when ruptured
  • Painful burning, itchy skin (more specific in irritant contact dermatitis)

Diagnosis is made with a patch test, and Treatment involves:

  • Calamine lotion is an itch relief cream
  • Antihistamine (Benadryl)
  • Hydrocortisone cream
  • Desitin cream Is a barrier cream that protects the skin from external irritation and retains moisture
  • Avoid itching the rash and use a cold compress on blisters

Seborrheic dermatitis (seborrhea)

Seborrheic dermatitis is a superficial fungal infection of the skin caused by Malassezia fungi that attack sebum-producing skin on the scalp, face, back, upper chest, and groin. There is no specific test for seborrhea, but a microscopic examination of skin scrape (biopsy) is recommended to rule out other skin diseases.

Risk Factor of Seborrhoea:

Signs and Symptoms of Seborrhoea: 

  • Dandruff (skin flakes on the scalp).
  • Skin flakes on eyebrows and beard
  • The patchy greasy crust on chest, ears, groin, and armpits.
  • Itching.
  • Red or brownish scaly patches

Treatment of Seborrhea:

  • Antifungal creams (Ketoconazole, ciclopirox, clotrimazole, fluconazole).
  • Coal tar.
  • Benzoyl peroxide.
  • Phototherapy.
  • Salicylic acid.
  • Antifungal shampoo.
  • Topical steroids.

Lastly, this is an informative article that informs the reader about dermatitis. If you experience similar dermatitis symptoms, be sure to consult a dermatologist.