Skin Disorders Guide

Almost any skin disease can become secondarily eczematized. Three factors determine the circumstances under which this is likely to happen. First, those patients who are genetically atopic (20% of the population) are particularly likely to initiate the itch-scratch cycle in the presence of almost any dermatologic condition. Second, lesions that occur in areas of sweat retention (groin, feet, scalp) and those that occur on skin likely to be xerotic (hands, lower legs) are much more likely to be scratched than those that occur elsewhere. Third, those diseases that are inherently pruntic are more likely to engender scratching than those that are non pruritic.Tt is apparent that any of the diseases from groups 1 through 9 will from time to time take on an excoriated, eczematous appearance. To the degree that this obscures the true nature of the underlying disease, one can simply (and temporarily) assign the condition to the eczematous disease group and then proceed to treat the itch-scratch cycle. Once this cycle has been interrupted (and the scratching has stopped), the true nature of the underlying codition can be recognized and more correctly reassigned.

This secondary eczematization is particularly likely to occur with psoriasis, dennatojhyte fungal disease, and candidiasis. In situations such as these, the process involved is very much. Analogous to the development of stasis dermatitis in patients willI stasis and to the development of dyshidrotic eczema in patlients with dyshidrosis.

Dennatitis hepetiformis, like scabies, represents a special use. Both of these conditions, though basically vesicular in nature, are so severely pruritic that they are virtually always excoriated and eczematized. Thus, though scabies and dermilitis herpetiformis are listed in both the vesiculobullous group and the eczematous group, they will present as eczematous diseases about 95% of the time.