All cases in Eczema and Related Disorders

Chilblains-like eczema

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A 50-year-0ld woman with long history of atopic dermatitis presented in winter with chilblains-like pruritic, red-purplish, scaly patches and plaques with some fissures and erosions involving  chiefly the hands especially the dorsal surface of the fingers and also the feet with few lesions on the trunk of two months duration. A superpotent corticosteroid in ointment base (Clobetasol) twice daily plus antihistaminics greatly improved the rash within 2 weeks.

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Phototoxic dermatitis

Phototoxic dermatitis
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A 38-year- old woman with burning-painful unilateral rash on one shin of 3 days duration. The patient suffered vitiligo on lower legs of many months duration. She had been treated with topical trisoralen solution plus sun light exposure at day time and combined mometasone furoate and tacrolimus in ointment base at night. One day after commecement of treatment she developed a localized but severe bullous rash confined strictly to the vitiliginous area on which the solution had been applied. This phototoxic (irritant contact) dermatitis reaction is commonly encountered in daily practice even sometimes with many folds dilution of trisoralen solution.

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Nummular eczema

Nummular eczema

A 4-year male toddler with positive personal and family history of atopic dermatitis presented with somehow demarcated severely pruritic red scaly plaque with few fine fissures on the top of right foot of 3 weeks duration in addition to generalized mildly xerotic skin. KOH wet mount preparation for dermatophytes was negative. No significant response to two weeks topically applied Tacrolimus ointment but adding topical betamethasone valerate ointment later has resulted in very good improvement. Discoid eczema in children may present de novo or may be part of atopic dermatitis.  

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Impetiginized discoid eczema

Impetiginized discoid eczema

A 50-year-old woman presented with nummular, oozy and crusted red plaque associated with itching and mild tenderness. Another small disc-like plaque was seen near the ankle area of same limb. Oral cephalexin 250 mg four times daily plus combined steroid-antibiotic cream (Betamethasone plus Fusidic acid) twice daily for two weeks yielded excellent response.

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Nummular eczema

An 8-year-old girl presented with a solitary, disc-like, red scaly patch on one leg of three weeks duration. The border seems to be more active than the center of the lesion, however KOH examination of the scales was negative and there was positive family history of atopic dermatitis. Excellent response to mometasone furoate 0.1%  ointment applied twice daily for two weeks. DSC05205

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