Asteatotic Eczema: Symptoms and Treatment

Asteatotic eczema occurs in old age; it is characterized by dry and cracked skin and often has moderate signs of eczematization. The causes of this form of eczema may include a decrease in lipids and the body’s water reserve due to age, co-morbidities or poor diet, heavy use of soaps and other skin cleansers, repeated microtrauma, low humidity and dry cold winds, contact with skin irritants, use of medications (diuretics, cimetidine, glucocorticosteroids), zinc, linoleic or linolenic acid deficiency.

Asteatotic eczema occurs most often on the shins, forearms, or palms. In addition to dry skin, there is usually itching and, as a result, scratching, redness, crusts, and swelling.

Eczema is an inflammatory disease of the skin. It has acute and chronic forms, prone to recurrence. Eczema was initially a type of dermatitis, but in the twentieth century, it began to be classified as a separate disease. Nevertheless, it is a common disease (in twenty cases out of one hundred visits to a dermatologist). 

Asteatotic Eczema

One form of the disease is asteatotic (dry) eczema. It develops very slowly, is seasonal, and can occur in any body area. This eczema is due to skin dehydration due to various factors such as aging, atopy, dry climate, increased contact with water and detergents, and malnutrition. Men are affected slightly more often than women.

The Symptoms of Asteatotic Eczema

The symptoms of asteatotic eczema are dry, itchy, fissured, and cracked skin with irregular scaling (eczema craquelé). Usually manifests initially on the shins (resembling a mosaic patch) but may also appear on the upper arms, thighs, and lower back. Asteatotic eczema can cause pain and itching and primarily affects people over 60.

Eczema manifests itself individually, depending on the patient’s type, stage, and characteristics. However, in general, a similar clinical picture can be traced, which is characterized by symptoms such as:

  • Redness and inflammation of a small area of skin;
  • dry rash;
  • a persistent, intense sensation of itching;
  • the formation of fissures on the site of inflammation;
  • increased body temperature;
  • crusts formation.

When the disease develops into a chronic form, the affected areas of skin become inelastic, with a pronounced skin pattern. In addition, intense and painful cracks are likely to form.

Since eczema has so many types and manifestations, distinguishing it is necessary to determine the Asteatotic form from the others. Skin lesions caused by eczema appear to be inflamed, moist swollen patches. They may join together to form blisters filled with fluid. Dry eczema causes the skin to dry out.

Why Does Asteatotic Eczema Occur?

The causes that have become catalysts for asteatotic eczema are divided into two types:

  1. Internal

Internal causes are usually liver and gastrointestinal disorders that are not detected in the early stages. Genetic predisposition and psychogenic factors also belong to this type. For example, prolonged nervous tension always contributes to the deterioration of the skin to varying degrees.

  1. External

External causes can be contacted (direct skin exposure to chemicals) or non-contact (prolonged exposure to dry air). In most cases, external factors influence the onset of eczema, as they are always sudden and unpredictable.

In short, we can say that the causes of Asteatotic Eczema are the following factors:

  • constitutionally dry skin,
  • age-related skin trophic disorders,
  • excessive use of detergents containing degreasing components,
  • low air humidity,
  • intake of diuretics,
  • hypothyroidism.

Most often, the disease is caused by several of the above factors.

The Diagnosis of Asteatotic Eczema

Asteatotic eczema has a characteristic symptomatic form so that it can be diagnosed accurately during the initial examination. The difficulty arises in determining the specific type of eczema since some varieties are very similar. But the treatment method of the asteatotic form is very different from that of the other types of this disease. The main complaint of patients is itching, sometimes quite pronounced.

Asteatotic Eczema

Clinically, asteatotic eczema is confluent erythema with indistinct borders and characteristic mosaic cracks on the surface, giving foci of rashes the appearance of a “dried river bed”; coarse scaly peeling are typical, and exacerbations are not uncommon. Classically, rashes appear on the anterolateral surfaces of the lower legs; lesions may also appear on the forearms and hands and occasionally on the trunk. The process is typically symmetrical.

The course of Asteatotic eczema is wave-like. The disease lasts for months and years, with exacerbations in the winter months and improvements in the summer and fall. Without treatment, it can develop a pattern of microbial or coniform eczema.

Treatment of Asteatotic Eczema

It is essential to start treatment of asteatotic eczema because neglected cases can cause significant discomfort to the patient and cause disruption of the various organs. 

Treatment recommendations:

  • shower as quickly as possible; avoid hot water;
  • do not use soap or other harsh cleansers on eczema-affected areas of the body;
  • after washing, apply a solid moisturizer to the skin;
  • use a moisturizer several times a day;
  • use creams containing topical corticosteroids.

Treatment of asteatotic eczema consists of using medium-acting topical steroids in the form of ointments; moisturizers are mandatory. Elderly patients in wintertime are recommended to have a room humidifier; it is desirable to exclude skin contact with woolen and synthetic fabrics. In addition, correction of concomitant pathology, if present, is carried out.

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