Asteatotic eczema

Synonym(s)

Asteatotic dermatitis; eczema craquelé; eczema craquelatum; xerotic eczema; eczema hiemalis; eczema fendille; etat craquelé

Definition

Pruritic, cracked, and fissured skin occurring most commonly on the shins of elderly patients, caused by lack of moisture in the skin

Pathogenesis

Physiologic process with aging; seen more often in the winter, with cold air outside and heated air inside causing a decrease in humidity; loss of water by stratum corneum causing cells to shrink and creating fine fissures; eczematous changes resulting from patients rubbing and scratching these pruritic areas

Clinical manifestation

Minimally scaly, red, cracked, and or fissured skin, giving the appearance of a “cracked pot” most commonly involving the pretibial areas, but also the thighs, hands and trunk; generalized pruritus, often worse after bathing

Differential diagnosis

Ichthyosis; atopic dermatitis; nummular eczema; stasis dermatitis; contact dermatitis; mycosis fungoides; other causes of...