DERMATITIS AND ECZEMATOUS DISORDERS Dr. Abdulmajeed Alajlan Associate Professor Consultant Dermatologist & Laser surgeon Department of Dermatology- KSU

Dermatitis Objectives  To know the definition & classification of Dermatitis/Eczema  To recognize the primary presentation of different types of eczema  To understand the possible pathogenesis of each type of eczema  To know the scheme of managements lines

Eczema  Definition: inflammation of the skin  Ezema vs. dermatitis

 Classification: Types of classification Benefit of classification Eczema

 Acute eczema: erosion, oozing and vesicles Eczema

 Chronic eczema: lichenification, drak pigmentation and thick papules and plaques Eczema

Contact Dermatitis

 Definition: dermatitis results from contact with external materials Contact Dermatitis

 Pathogenesis:  Irritant vs. allergic  Common irritants: detergent, acids, dust, burning chemicals, etc  Common allergens: perfumes, hair dyes, nickels, leathers, metals, rubbers, latex, cosmetics, etc Contact Dermatitis

 Clinical features  Prediliction sites:  Distribution & configuration Contact Dermatitis

 Management:  Identification  Patch testing: for allergic contact dermatitis not for irritant  Avoidance measures  Topical corticosteroids Contact Dermatitis

Atopic Dermatitis

Atopic Dermatits  Definition: chronic relapsing itchy skin disease in genetically predisposed patients. Associated diseases: bronchial asthma, allergic rhinitis, allergic congectivitis  Incidence: up to 15% in developed countries  Grow out tendency!

 Pathogenesis: “Atopy”: genetic predisposition Dry skin (decrease production of moisturizing lipids; sebum) IgE ? (Epiphenomenon) T-Cell Allergy, increased tendency to certain allergens Atopic Dermatitis

 Clinical Variants: Infantile AD Childhood AD Adult AD Atopic Dermatitis

 Infantile AD: Distribution Presentation Behaviour Atopic Dermatits

 Childhood AD: Distribution Presentation Behaviour Atopic Dermatits

 Adult AD: Distribution Presentation Behaviour Atopic Dermatits

Erythroderma: is a very rare complication of atopic dermatitis

 Complications:  Secondary infections  Eczema herpeticum  Growth retardation  psychological Atopic Dermatits

Cellulitis

Impitigo: Bacterial infection

Eczema Herpiticum is a serious complicaiton that needs admission and systemic antiviral

 Investigations: ???????? Atopic Dermatits

 Management:  Education! Education! Education!  Support!  Skin care: moisturizing the skin  Topical therapy: (topical steroids, Tacrolimus, Pimecrolimus)  Phototherapy  Systemic therapy: steroids, Cyclosporin, Methotrexate, Azathioprine

 AD and Food! minor role Atopic Dermatits

Seborrhoeic Dermatitis

 Definition: Seborrhoeic Dermatits

 Pathogenesis: increased Sebum! Tendency Pityrosporum ovale over growth Seborrhoeic Dermatits

 Clinical features: Presentation Distribution Seborrhoeic Dermatits

 Investigations : ?????  Resistant cases think of: Histocytosis (langerhans cell neoplasm) Seborrhoeic Dermatits

 Management:  Shampoo  Antigungals  Topicals  Combined therapy  Maintenance & recurrence Seborrhoeic Dermatits

Dermatitis Objectives  To know the definition & classification of Dermatitis/Eczema  To recognize the primary presentation of different types of eczema  To understand the possible pathogenesis of each type of eczema  To know the scheme of managements lines