ASTEATOTIC DERMATITIS
ASTEATOTIC DERMATITIS ICD-10: L30.9
• A common pruritic dermatitis that occurs especially in older persons, in temperate climates during the winter—related to the low humidity of heated houses.
• The sites of predilection are the legs (Fig. 2-25), arms, and hands but also the trunk.
• Dry, “cracked,” superficially fissured skin with slight scaling.
• The incessant pruritus can lead to lichenification, which can even persist when the environmental conditions have been corrected.
• The disorder results from too frequent bathing in hot soapy baths or showers and/ or in older persons living in rooms with a high environmental temperature and low relative humidity.
• Management: Avoiding overbathing with soap, especially tub baths, and increasing the ambient humidity to >50%, by using room humidifiers; also using tepid water baths containing bath oils for hydration, followed by immediate liberal application of emollient ointments, such as hydrated petrolatum. If skin is inflamed, use medium-potency glucocorticoid ointments, applied twice daily until the eczematous component has resolved.
Synonyms: Eczema craquelé (French craquelé, “marred with cracks”).
FIGURE 2-25 • Asteatotic dermatitis “Cracked” patches on the leg of an older patient.