Dermatitis: Possible Complications
A number of
complications can arise with atopic dermatitis. Some are relatively
common; others extremely rare:
experiencing one of the complications described below should contact
a dermatologist, or visit an emergency room if the condition becomes
dermatitis is frequently seen in people with a history of atopic
dermatitis, especially adults. The condition often begins with dry,
chapped hands that later become patchy, red, scaly, and inflamed.
Some patients report a seasonal worsening of hand dermatitis,
usually during the winter. Hand dermatitis is commonly aggravated
wetting the hands
washing with soaps, detergents, or disinfectants
exposing the hands to water and cleansing or disinfecting agents
while doing everyday tasks, such as laundry and washing dishes
This usually consists of:
exposure, as needed, to factors that aggravate the hand dermatitis
moisturizers and medications as prescribed by a dermatologist
corticosteroids are frequently part of the treatment plan. Numerous
corticosteroids of various types and strengths are available, and
dermatologists prescribe these as needed to accommodate the
individual patient’s needs. These medications are not suitable for
every patient. It is extremely important that patients use these
medications only as prescribed.
When one is not
able to limit exposure to water and harsh soaps, detergents,
disinfectants, or other irritant chemicals, hand dermatitis can
become tremendously difficult to treat. This tends to happen when a
job or occupation requires constant exposure to such irritants.
Teens and others considering a possible job or occupation should
take this into consideration. Choosing an occupation that does not
involve repeated exposure will help minimize future risk.
Recurrent bacterial, fungal, and viral skin infections are a frequent
complication of atopic dermatitis. It is believed that the lesions
of atopic dermatitis provide an environment that allows bacteria,
fungi, and viruses to easily invade the skin and replicate.
The lesions of
atopic dermatitis provide an environment that can harbor several
types of harmful bacteria. One most commonly found -
and the one most likely to produce recurrent and/or serious
infections - is Staphylococcus aureus, (S. aureus),
better known as "staph." Studies have shown that S. aureus is
far more common on the skin of patients with atopic dermatitis than
on the skin of persons who do not have this condition. S. aureus
may be harbored in atopic dermatitis skin lesions, on unaffected
skin, or in the nose of the patient.
While the S.
aureus organisms may be present without causing any apparent
symptoms, a reservoir of S. aureus creates the potential for
The typical signs
and symptoms of an infection are:
Yellowish-orange or honey-colored crusting (impetigo) over the
inflamed hair follicles (folliculitis)
Anti-staphylococcal drugs are usually effective in treating an acute
S. aureus infection. If the infection occurs again and again,
a reservoir of S. aureus may be present. If present, it is
treated with an appropriate antibiotic.
simplex, the virus that causes cold sores, enters an atopic
dermatitis skin lesion, it can cause eczema herpeticum - a
severe and potentially life-threatening infection. While not common,
eczema herpeticum occurs in people of all ages and in males
and females. Often those infected do not know that they have been
exposed to the herpes simplex virus.
indication of infection occurs 5 to 12 days after exposure to the
virus and typically appears as multiple itchy, watery blisters that
occur on skin previously affected by atopic dermatitis. If these
blisters are not treated, they can become progressively worse as
illustrated by these stages:
Multiple itchy, watery blisters over
an area of skin, usually where atopic dermatitis lesions were
present. (5 to 12 days after exposure)
Blisters tend to disseminate or
"crop" into adjacent areas of skin.
Blisters may bleed, become
encrusted, and erode - at this stage they are extremely painful.
The viral infection spreads to cover
the entire body, with associated fever and swollen lymph nodes.
Secondary bacterial infection frequently develops in large, eroded
areas of skin.
stages, fever is usually present and the person feels ill. The first
episode of eczema herpeticum usually runs its course in 2 to 6 weeks
if left untreated. However, letting the disease run its course is
not recommended as eczema herpeticum can be life-threatening.
Subsequent outbreaks tend to be milder, unless the patient has an
underlying immunodeficiency condition.
herpeticum is potentially life-threatening, medical care should be
sought. When therapy begins early, eczema herpeticum can be
effectively treated. Several anti-viral medications are available,
and a dermatologist can prescribe the one best suited for the
individual. Pain medications also may be helpful.
that may complicate atopic dermatitis include molluscum contagiosum
and human papillomavirus. If a virus is suspected, a dermatologist
may order diagnostic tests to determine which virus is involved so
that proper therapy can be prescribed.
complications tend to be most common in patients with severe atopic
complications occur, the associated eyelid itching can be almost
unbearable. Some eye complications can lead to permanent eye damage
and loss of vision. Signs and symptoms of eye complications include:
the eyelid (blepharitis) and the lining of the eyelids
(conjunctivitis), with symptoms of extreme itching, burning,
watering of the eyes, and mucous discharge.
the inner lining of the eyelids that causes a cobblestone pattern
to develop under the eyelids. Symptoms include extreme itching and
deformed, probably due to constant hard rubbing of the eyes caused
by excruciating eyelid itching.
signs and symptoms should be reported to a dermatologist
immediately, so that the condition can be diagnosed and treated.
Sometimes complications affecting the eye require the help of an
rare complication of severe atopic dermatitis, exfoliative
dermatitis is an inflammatory skin disorder. Lesions can cover most
of the skin’s surface, and severe cases may be life threatening.
Signs and symptoms include:
affects organs other than the skin
bacterial or viral infection (can be a major complication)
Water loss from
oozing lesions may cause the body to become dehydrated
Some cases of
exfoliative dermatitis resolve spontaneously. However, medical
treatment should begin as soon as possible to prevent
life-threatening complications from developing. Treatment may
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