๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
AUTOSENSITIZATION DERMATITIS
AUTOSENSITIZATION DERMATITISย ย ICD-10: L30.9
โข An often unrecognized generalized pruritic dermatitis directly related to a primary dermatitis elsewhere.
โข For example, a patient with venous stasis dermatitis on the lower legs may develop pruritic, symmetric, scattered, erythematous, maculopapular, or papulovesicular lesions on the trunk, forearms, thighs, or legs.
โข These persist and spread until the basic underlying primary dermatitis is controlled.
โข Similarly, autosensitization may occur as an โidโ reaction in inflammatory tinea pedis and manifests as a dyshidrosiform, vesicular eruption on the feet and hands (Fig. 2-22) and papulovesicular eczematoid lesions on the trunk.
โข The phenomenon results from the release of cytokines in the primary dermatitis, as a result of sensitization. These cytokines circulate in the blood and heighten the sensitivity of the distant skin areas.
โข The diagnosis of autosensitization dermatitis is often post hoc; that is, the distant eruption disappears when the primary dermatitis is controlled.
โข Oral glucocorticoids hasten the disappearance of the lesions.
FIGURE 2-22 โข Autosensitization dermatitis (โidโ reaction): dermatophytidโVesicles and bullae on the finger and the lateral foot of a 21-year-old female. Bullous (inflammatory) tinea pedis was present and was associated with dermatophytid reaction. Prednisone was given for 2 weeks; pruritus and vesiculation resolved.