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Chapter: Medicine Study Notes : Skin

Eczema Related Conditions

Discoid Eczema, Juvenile Plantar Dermatosis, Pompholyx (dyshidrotic eczema). Pityriasis Alba.

Other Eczema Related Conditions


Discoid Eczema


·        Descriptive term: round or oval, well circumscribed, red, scaly, +/- vesicular (® weepy)

·        In kids: often atopic

·        In Adults: often cause unknown

·        Differential: 

o   Ringworm: tends to be annular (worse at the edge). May have alopecia or pustules. Take scraping for culture.

o   Superficial BCC: doesn‟t usually itch, often a shiny surface, dots of pigment

o   Psoriasis: silvery scale, not weepy


Juvenile Plantar Dermatosis


·        Fissured dermatitis of the plantar surface of the forefoot – red, glazed, cracked, symmetrical, toe clefts normal

·        In children 3 – 14 years

·        Usually atopic

·        Treatment difficult: Urea creams, moisturisers, steroid creams.  Has usually resolved by teens.


Pompholyx (dyshidrotic eczema)


·        Not related to atopic eczema

·        Vesicles +/- bullae on palms, soles, sides of fingers or toes

·        Erythema or scaling absent.  If present then just a vesicular eczema

·        Heals with desquamation

·        Differential: fungal infection

·        Treatment: ?steroids


Pityriasis Alba


·        Round/oval, hypopigmented, fine lamellar scaling, from 5 – 20 mm, commonly on face

·        Usually age 3 – 16

·        Associated with atopy – but may be independent

·        No treatment – goes away by itself


Asteatotic Eczema


·        Related to dry skin

·        Usually on legs, usually diuretics, excessive washing or hypothyroidism

·        Superficial fissures create a crazy paving pattern

·        Treatment: soap substitute, moisturiser +/- topical steroid




·        Generic term for inflammatory dermatosis in skin folds (eg submammary or gentiocrural)

·        May be a form of atopic or seborrheic dermatitis

·        Can be secondarily infected with candida or staph

·        Treatment:

o   Reduce friction, avoid tight clothing

o   Mild steroid, antibacterial or anti-candida cream


Angular Cheilitis


·        Affects the fold of skin at the corner of the mouth.  Especially in denture wearers

o   May be a form of intertrigo, can be associated with atopic or seborrheic dermatosis

·        May be infected with candida or staph, may be folate deficiency, a frequent complication of Roaccutane treatment


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