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Background
- Must distinguish from Seborrheic Dermatitis
- Occurs between 2-6mo (somewhat later than seborrheic dermatitis)
- Pruritic (may manifest as fussiness) vs seborrheic (not pruritic)
Clinical features
- Atopic personal or family hx, worse in winter, dry weather
- Erythema, crusts, fissures, pruritis, excoriations, lichenification
Infantile
- blisters, crusts, exfoliations
- Face, scalp, extremities
- 1st few months of life, resolving by age 2
- Differentiate from impetigo (which may occur alongside)
Adults
- Dryness, thickening in AC and popliteal fossa, neck
Diagnosis
- Dry skin, erythematous papular lesions
- Face most commonly involved; nose and diaper areas spared
Differential Diagnosis
Complications
Treatment
- Identify and eliminate triggers
- Reduce drying of skin
- Liberal application of emollients (vaseline)
- Triamcinolone, hydrocortisone, or betamethasone
- Avoid fluoridinated steroids to the face
- Consider doxepin for recalcitrant pruritis[1][2]
- 25-50 mg PO qhs
- Or topical doxepin cream 5% QID
See Also
References
- ↑ Hercogova J. Topical anti-itch therapy. Dermatol Ther 18(4):341-3 (2005 Jul-Aug).
- ↑ Drake L, Cohen L, Gillies R, et al. Pharmakinetics of doxepin in subjects with pruritic atopic dermatitis. J Am Acad Dermatol 41(2):209-14 (1999 Aug).