II. Epidemiology

  1. Incidence increases with age (common in elderly)

III. Pathophysiology

  1. Related to abnormal keratin production
  2. Elderly have decreased skin Fatty Acids
    1. Results in decreased skin barrier and hydration

IV. Symptoms

  1. Pruritus without rash
    1. Itching may be intense
    2. Sporadic occurrence
  2. Common Areas involved
    1. Anterolateral lower legs (most commonly affected)
      1. Nummular lesions are common on the legs in the elderly (and often very pruritic)
    2. Back and Flanks
    3. Abdomen and waist
    4. Arms
  3. Areas spared
    1. Axilla
    2. Groin
    3. Face and scalp
  4. Provocative factors
    1. Worse with cold, dry weather
    2. Examples: Winter or air conditioning exposure
  5. Palliative factors
    1. Improves with warm, humid weather

V. Signs

  1. Mild changes
    1. Faint reticulate pinkness
    2. Fine scale or cracks seen with tangential light
    3. Often affects legs (especially shins)
  2. Moderate to severe changes
    1. Dramatic deep redness and cracking
      1. May appear as cracked porcelain (Eczema Craquele)
    2. Nummular Eczema type lesions

VI. Management

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Related Studies

Ontology: Vesicular eczema of hands and/or feet (C0032633)

Definition (SCTSPA) Erupción autolimitada de palmas y plantas
Definition (SNOMEDCT_US) Self-limited vesicular eruption of palms and soles
Definition (SNOMEDCT_US) Self -limited vesicular eruption of palms and soles
Definition (MSH) A recurrent eczematous reaction characterized by the development of vesicular eruptions on the palms and soles, particularly along the sides and between the digits. It is accompanied by pruritus, a burning sensation, and hyperhidrosis. The disease is self-limiting, lasting only a few weeks. (Dorland, 27th ed)
Concepts Disease or Syndrome (T047)
MSH D011146
ICD9 705.81
SnomedCT 25560004, 156416008, 201202007, 201199002, 274946003, 201200004, 201198005, 267865000, 156417004, 267866004, 402567004
English DYSHYDROSIS, DYSHYDROTIC ECZEMA, Dyshidrotic Eczemas, Dyshydrotic Eczemas, Eczema, Dyshidrotic, Eczema, Dyshydrotic, Eczema, Vesicular Palmoplantar, Eczemas, Dyshidrotic, Eczemas, Dyshydrotic, Eczemas, Vesicular Palmoplantar, Palmoplantar Eczema, Vesicular, Palmoplantar Eczemas, Vesicular, Pompholyx, Vesicular Palmoplantar Eczema, Vesicular Palmoplantar Eczemas, Dyshidrotic Eczema, Dyshydrotic Eczema, Dyshidrosis NOS, Vesic eczema of hands and feet, Dyshidrosis unspecified, Pompholyx unspecified, POMPHOLYX, dyshidrosis (diagnosis), dyshidrosis, Eczema, Dyshidrotic [Disease/Finding], vesicular eczema of hands and/or feet, eczema dyshidrotic, eczema dyshidrotic (diagnosis), dyshydrosis, pompholyx eczema, dyshidrotic hand eczema, dyshidrotic dermatitis, dishydrosis, dyshidrotic eczema, cheiropompholyx, Dyshidrosis, Dysidria, Dyshidrosis NOS (disorder), Dyshidrosis unspecified (disorder), Pompholyx (finding), Pompholyx unspecified (disorder), Dyshidrosis (disorder), Dysidrosis, Vesicular eczema of hands and/or feet (disorder), pompholyx, dyshydrotic; eczema, eczema; dyshydrotic, Dyshidrotic dermatitis, NOS, Dyshidrotic dermatitis, Dyshidrotic eczema, Dyshidria, Cheiropodopompholyx, Pompholyx eczema, Vesicular eczema of hands and feet, Cheiropompholyx, Vesicular eczema of hands and/or feet, dyshydrotic eczema, Eczema;dyshidrotic
Swedish Eksem, dyshidrotiskt
Czech ekzém dyshidrotický, pomfolyx, Dyshidrotický ekzém, Dyshidróza
Finnish Dyshidroosi
Italian Pompholyx, Eczema vesicolare palmoplantare, Ponfolice, Disidrosi, Eczema disidrosico, Disidrosi eczematosa, Eczema disidrotico
Portuguese DESIDROSE, Desidrose, Eczema desidrótico, Eczema Disidrótico, Eczema Vesicular Palmar e Plantar, Ponfolix
French DYSIDROSE, Dyshidrose bulleuse, Eczéma dyshidrotique, Eczéma dyshidrosique, Dyshidrose, Pompholyx, Dysidrose
Polish Potnica, Wyprysk potnicowy
Japanese 湿疹-汗疱状, 異汗性湿疹, イカンセイシッシン, カンポウ, 汗疱性湿疹, カンポウセイシッシン, 汗疱, 汗疱状湿疹, 胞状掌蹠湿疹, 湿疹-胞状掌蹠
Norwegian Dyshidrotisk eksem, Pompholyx
Dutch dyshidrotisch eczeem, pompholyx eczeem, dyshidrose, pompholyx, dyshidrotisch; eczeem, eczeem; dyshidrotisch, Dyshidrotisch eczeem, Eczeem, dyshidrotisch, Eczeem, vesiculair palmoplantair, Pompholyx, Vesiculair palmoplantair eczeem
German dyshidrotisches Ekzem, Pompholyx eczema, Ekzem, dyshidrotisches, Cheiropompholyx, Dyshidrose, Dyshidrosis, Dyshidrotisches Ekzem, Podopompholyx, Pompholyx, Ekzem, vesikuläres, palmoplantares, Vesikuläres palmoplantares Ekzem
Hungarian Dyshidrosis, Pompholyx, Dyshidroticus eczema, Pompholyx eczema
Spanish Dishidrosis, Eczema ponfólix, Ezcema dishidrótico, dishidrosis, SAI, ponfólix no especificado (trastorno), dishidrosis, SAI (trastorno), dishidrosis (trastorno), dishidrosis no especificada, eccema dishidrótico, dermatitis dishidrótica, dishidria, ponfólice, dishidrosis no especificada (trastorno), ponfólix, eczema dishidrótico, ponfólix no especificado, dishidrosis, eccema vesicular de manos y/o pies (trastorno), eccema vesicular de manos y/o pies, eczema vesicular de manos y/o pies, Eccema Dishidrótico, Eccema Vesicular Palmoplantar, Ponfólix

Ontology: Dry skin (C0151908)

Definition (NCI_CTCAE) A disorder characterized by flaky and dull skin; the pores are generally fine, the texture is a papery thin texture.
Definition (NCI) The pores are generally fine with a papery thin texture that feels dry to the touch. Usually flaky and dull looking.
Definition (NCI_CDISC) The pores are generally fine with a papery thin texture that feels dry to the touch. Usually flaky and dull looking.
Concepts Sign or Symptom (T184)
SnomedCT 16386004
LNC LA17199-3
English SKIN DRY, Dry skin, dry skin, dry skin (physical finding), dry skin (symptom), Dry Skin, skin dryness, Dry;skin, Skin dry, DRY, Dry, Anhydrotic skin, Dry skin (finding)
Italian Cute secca, Pelle secca
French Peau sèche, SECHERESSE CUTANEE, Sécheresse cutanée
German Haut trocken, HAUTTROCKENHEIT, trockene Haut
Portuguese Pele seca, PELE SECA, Xerose cutânea
Japanese 皮膚乾燥, ヒフカンソウ
Spanish PIEL SECA, piel seca (hallazgo), piel seca, Piel seca
Czech Suchá kůže
Hungarian Bőr száraz, Száraz bőr
Dutch droge huid

Ontology: Xerosis (C0259817)

Concepts Disease or Syndrome (T047)
English XEROSIS, Xerosis, xerosis
Italian Xerosi
Japanese 乾燥症, カンソウショウ
French XEROSE, Xérose
Portuguese XEROSE, Xerose
German XEROSIS, Xerose
Spanish XEROSIS, Xerosis
Czech Xeróza
Hungarian Xerosis
Dutch xerose

Ontology: Asteatotic eczema (C0549201)

Concepts Disease or Syndrome (T047)
ICD10 L85.3
SnomedCT 201077008, 261852004, 238596006, 260956008, 201064004, 7867008, 238595005, 260046006, 201025002, 400051008
English Xerotic eczema, Prurigo hiemalis, ECZEMA ASTEATOTIC, winter itch, winter itch (diagnosis), Eczema asteatotic, eczema asteatotic, winter eczema, asteatosis, eczema xerotic, pruritus hiemalis, eczema craquele, asteatotic eczema, dry skin dermatitis, xerotic eczema, Eczema craquel, Prurigo hiemalis (disorder), Pruritus hiemalis (disorder), Dry skin dermatitis, Winter itch, Asteatotic eczema, Eczema craquele, Pruritus hiemalis, Acquired xeroderma, Winter eczema, Dry skin dermatitis (disorder), Eczema craquelé, Asteatotic eczema (disorder), Winter itch (disorder), dry skin; eczema, eczema; dry skin, itch; winter, acquired; xeroderma, winter; itch, xeroderma; acquired, Pruritus hiemalis (disorder) [Ambiguous], Asteatotic eczema [Ambiguous], Asteatosis, Pruritus, hiemalis
Dutch asteatose, xerotisch eczeem, winterjeuk, craquelé-eczeem, droge huid; eczeem, eczeem; droge huid, jeuk; winter, verworven; xerodermie, winter; jeuk, xerodermie; verworven, asteatotisch eczeem
French Astéatose, Prurit hivernal, Eczéma xérodermique, Eczéma astéatotique, ECZEMA SEC, Eczéma craquelé
Italian Asteatosi, Eczema asteatotico, Prurito invernale, Eczema asteatosico, Eczema escoriato, Eczema xerotico
Portuguese Asteatose, Prurido de Inverno, Eczema asteatótico, Eczema xerótico, ECZEMA ASTEATOTICO, Eczema esteatótico
Spanish Asteatosis, Eczema invernal, Eczema en craquelé, Eczema xerótico, eccema asteatósico, eccema craquelé, eccema asteatótico, eccema xerótico, eccema agrietado, eccema invernal, eczema xerótico, eczema xerótico (trastorno), piel ajada, prurigo invernal, eczema invernal, eccema de invierno, eccema agrietado (trastorno), eczema asteatósico, dermatitis seca de la piel, prurigo invernal (trastorno), dermatitis de la piel seca (trastorno), dermatitis de la piel seca, eccema craquelé (trastorno), eczema craquelé, prurito invernal (concepto no activo), prurito invernal (trastorno), prurito invernal, xeroderma adquirido, Eczema esteatósico
German asteatotisches Ekzem, Winterjucken, xerotisches Ekzem, Eczema craquele, EKZEM ASTEATOTISCH, Ekzem asteatotisch, Asteatose
Japanese 皮脂欠乏性湿疹, 皮脂欠乏症, 乾燥性湿疹, 亀裂性湿疹, 冬期そう痒, キレツセイシッシン, ヒシケツボウセイシッシン, ヒシケツボウショウ, トウキソウヨウ, カンソウセイシッシン
Czech Ekzém v chladném prostředí, Eczema craquele, Asteatotický ekzém, Xerotický ekzém, Asteatóza
Hungarian Téli viszketés, Eczema craquele, eczema, asteatoticus, Asteatotikus eczema, Asteatosis, Asteatoticus eczema