Clinical Approach to Regional Dermatoses

Published on 05/03/2015 by admin

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Last modified 05/03/2015

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Clinical Approach to Regional Dermatoses

• Some inflammatory, infectious, metabolic, neoplastic, and genetic skin conditions have a predilection for particular areas of the body.

• This chapter addresses the diagnosis and treatment of regional dermatoses affecting the hands, feet, intertriginous regions, diaper area, lips, and eyelids.

Dermatitis of the Hands and Feet

• An approach to the classification of hand dermatitis is presented in Fig. 13.1, and the differential diagnosis of foot dermatitis is summarized in Table 13.1.

Fig. 13.1 Classification of hand dermatitis. More than one etiology may be present, e.g. atopic dermatitis plus irritant contact dermatitis. FH, family history; PH, personal history. Courtesy, David E. Cohen, MD.

Table 13.1

Differential diagnosis of foot dermatitis.

• Because the hands and feet have a thicker stratum corneum than other areas of the body, percutaneous absorption of topical medications is decreased.

• High-potency topical CS or the use of occlusion may be needed to effectively treat inflammatory dermatoses in these sites.

Intertriginous Dermatitis

• Intertriginous areas include the inguinal creases, gluteal cleft, axillae, inframammary folds, and beneath pannus in obese patients.

• The differential diagnosis of dermatitis in the major skin folds is presented in Fig. 13.2.

Table 13.2

Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE): clinical criteria.

This entity is also referred to as drug-induced intertrigo, flexural drug eruption, and baboon syndrome. The latter term is also used for a form of systemic contact dermatitis.

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