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Dermatitis (Eczema)

» What is dermatitis and why is it so important?
» What is atopy?
» Why is atopic dermatitis becoming more common?
» What are the diagnostic criteria for atopic dermatitis?
» What is the underlying defect in patients with atopic dermatitis?
» In atopic dermatitis, which comes first - the itch or the rash?
» Why does atopic dermatitis itch?
» Why do people like to scratch an itch?
» Does psychological stress worsen atopic dermatitis?
» Did John Phillip Sousa write the “Atopic March?”
» How does atopic dermatitis present at different ages?
» What physical findings are associated with atopic dermatitis? 
» What factors provoke or exacerbate atopic dermatitis? 
» How can your atopic patients relieve their pruritic agony and discomfort? 
» What is the role of antihistamines in atopic dermatitis?
» Describe the “two-pajamas treatment.”
» Is “hand dermatitis” a specific entity?
» What is pompholyx?
» How can pompholyx be managed?
» Describe the typical presentation of nummular eczema.
» What causes nummular eczema?
» Is there a cure for nummular eczema?
» How does seborrheic dermatitis present in children?
» How does seborrheic dermatitis present in adults?
» What causes seborrheic dermatitis, and with what disease states is it commonly found?
» Discuss the treatment approaches to seborrheic dermatitis. 
» What is an “id” reaction, and what does it have to do with Sigmund Freud?
» What are the most common settings for an id reaction and how should you treat it?
» What do you call dermatitis that covers virtually the whole cutaneous surface?
» How can you determine the cause of a patient’s exfoliative dermatitis?
» What general treatment measures are used to treat patients with exfoliative dermatitis?

 
 
 

What are the most common settings for an id reaction and how should you treat it?

Severe papulosquamous id reaction of the lower legs secondary to a severe dermatophyte infection. (Courtesy of James E. Fitzpatrick, MD.)
Fig. 8.5 Severe papulosquamous id reaction of the lower legs secondary to a severe dermatophyte infection. (Courtesy of James E. Fitzpatrick, MD.)
Stasis dermatitis, scabies, and dermatophyte infections (Fig. 8-5) are the most common settings. The distant lesions often take on the characteristics of the primary cutaneous lesions. The cure lies in treating the primary lesion because, by definition, an id reaction resolves when the primary dermatitis departs. Many id reactions require symptomatic treatment with antipruritics, wet-to-dry soaks, and topical corticosteroids. Often, systemic corticosteroids are necessary to bring relief.