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Dermatitis

Condition Overview:

Dermatitis (eczema) is inflammation of the upper layers of the skin, causing itching, blisters, redness, swelling, and often oozing, scabbing, and scaling.

Dermatitis is a broad term covering many different disorders that all result in a red, itchy rash. The term eczema is sometimes used for dermatitis. Some types of dermatitis affect only specific parts of the body, whereas others can occur anywhere. Some types of dermatitis have a known cause; others do not. However, dermatitis is always the skin's way of reacting to severe dryness, scratching, a substance that is causing irritation, or an allergen. Typically, that substance comes in direct contact with the skin, but sometimes the substance is swallowed. In all cases, continuous scratching and rubbing may eventually lead to thickening and hardening of the skin.Dermatitis may be a brief reaction to a substance. In such cases it may produce symptoms, such as itching and redness, for just a few hours or a day or two. Chronic dermatitis persists over a period of time. The hands and feet are particularly vulnerable to chronic dermatitis, because the hands are in frequent contact with many foreign substances and the feet are in the warm, moist conditions created by socks and shoes that favor fungal growth.Chronic dermatitis may represent a contact, fungal, or other dermatitis that has been inadequately diagnosed or treated, or it may be one of several chronic skin disorders of unknown origin, such as pompholyx (see Itching and Noninfectious Rashes: Pompholyx) or hyperkeratotic palmar eczema. Because chronic dermatitis produces cracks and blisters in the skin, any type of chronic dermatitis may lead to bacterial infection.

Regardless of cause or type, contact dermatitis results in itching and a rash. The itching is usually severe, but the rash varies from a mild, short-lived redness to severe swelling and large blisters. Most commonly, the rash contains tiny blisters. The rash develops only in areas contacted by the substance. However, the rash appears earlier in thin, sensitive areas of skin, and later in areas of thicker skin or on skin that had less contact with the substance, giving the impression that the rash has spread. Touching the rash or blister fluid cannot spread contact dermatitis to other people or to other parts of the body that did not make contact with the substance.

Determining the cause of contact dermatitis is not always easy. Most people are unaware of all the substances that touch their skin. Often, the location of the initial rash is an important clue, particularly if it occurs under an item of clothing or jewelry or only in areas exposed to sunlight. However, many substances that people touch with their hands are unknowingly transferred to the face, where the more sensitive facial skin may react even if the hands do not.