Dry

Dry Skin

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Dry Skin, Xerotic Eczema, Dyshidrotic Eczema, Xerosis, Asteatotic Eczema, Eczema Craquele, Pompholyx

  • Epidemiology
  1. Incidence increases with age (common in elderly)
  • Pathophysiology
  1. Related to abnormal keratin production
  2. Elderly have decreased skin Fatty Acids
    1. Results in decreased skin barrier and hydration
  • 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
  • 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
  • Management
  1. See Dry Skin Management