ASTEATOTIC ECZEMA

• It is also called as Eczema craquele, winter eczema, Dermatitis Sicca . It is often found in elderly people, though it is not uncommon for people in their 20s. Seasonality is prominent and most people develop symptoms in winter months
• Many people who develop asteatotic eczema in old age will have a dry skin and a tendency to chap

• It is an eczema associated with a decrease in skin surface lipids
• Water loss from the stratum corneum
• Environmental factors : Low humidity
• Hypothyroidism

• The eczema occurs after excessive drying , especially during the winter months and among the elderly and those with atopic dermatitis or Ichthyosis vulgaris
• Usually affects lower legs in elderly
• The skin of the limbs and trunk is erythematous, dry and itchy and shows a fine crazy paving pattern of fissuring
• Diamond shaped plates of skin are separated from each other by red bands forming a network. There may also be scratch marks
• Severe asteatotic eczema can lead to more severe secondary dermatitis with generalised redness, localised swelling and surface blistering and it can eventually result in widespread secondary disseminated eczema

Differential diagnosis :

• Atopic Dermatitis
• Acquired Icthyosis

• Usually clinical diagnosis is made

• Avoidance of frequent bath
• Regular lubrication of skin
• Soak and smear method of hydrating the skin by bathing and soaking the affected area followed by immediate application of shatadhouta ghrita/ Tiktaka ghrita / Jeevanthyadi yamaka. This is best performed at night

Internal medicines

• Panchatiktaka kashaya
• Chandraprabha gutika
• Mahatiktaka ghrita – samana sneha

Procedures

• Paranthyadi kera dhara
• Shatadhouta ghrita ext application
• Virechana with Avipathi choorna