II. Epidemiology
- More common in Atopic Patients (Atopic Dermatitis)
III. Pathophysiology
- Response to chronic Atopic Dermatitis
IV. Symptoms
- Bouts of intense itching
- Rash does not appear until after scratching starts
- Rash may appear spontaneously
-
Itching awakens person from sound sleep
- Scabies and Rhus Dermatitis prevent getting to sleep
- Associated with emotional stress or depressed mood
V. Signs
- Characteristics
- Red Papules and Plaques
- Overlying lichenification
- Sites of involvement
VI. Differential Diagnosis
VII. Complications
VIII. Management
- See Pruritus Management
- Maximize management of Atopic Dermatitis
- Frequent application of Skin Lubricants
- Replaces the habit of scratching
- Bedtime Antihistamines
- Topical antipruritics
-
Topical Corticosteroids
- For inflammatory rash
- Occlusion helpful for lichenified areas
- Intralesional steroids
- Consider in scalp-picker's Nodules
- Systemic Steroids
- Consider in severe refractory cases
- Prednisone 20 mg qd for 14 days
- Occlusion
IX. References
- Habif (1996) Clinical Dermatology, Mosby, p. 69