Dermatitis

Dermatitis – Comprehensive Comparison Table

 
Type of Dermatitis Primary Cause / Pathophysiology Common Sites Key Clinical Features Common Triggers First-Line Treatment Pharmacist Clinical Pearls
Atopic Dermatitis (Eczema) Chronic inflammatory skin disease; impaired skin barrier; IgE-mediated Face, neck, flexural areas Pruritus, dry skin, erythema, lichenification Allergens, stress, infections, dry climate Emollients, topical corticosteroids, topical calcineurin inhibitors Avoid long-term high-potency steroids; moisturizers are foundational
Contact Dermatitis – Irritant Direct chemical/physical damage to skin Hands, exposed areas Erythema, dryness, burning > itching Soaps, detergents, acids, solvents Avoid irritant, topical corticosteroids Patch testing negative; dose-dependent reaction
Contact Dermatitis – Allergic Type IV delayed hypersensitivity reaction Hands, face, eyelids Intense pruritus, vesicles, edema Nickel, fragrances, latex, poison ivy Allergen avoidance, topical corticosteroids Patch testing positive; sensitization required
Seborrheic Dermatitis Inflammatory response to Malassezia yeast Scalp, face, chest Greasy scales, erythema, dandruff Stress, neurologic disease, HIV Antifungal agents (ketoconazole), low-potency steroids Chronic-relapsing; antifungals are key
Stasis Dermatitis Venous insufficiency → edema & inflammation Lower legs, ankles Erythema, scaling, hyperpigmentation Chronic venous disease Compression therapy, topical steroids Rule out cellulitis; compression is essential
Nummular Dermatitis Unknown; associated with dry skin Extremities Coin-shaped pruritic plaques Cold weather, dry skin Medium–high potency topical steroids Often mistaken for fungal infection
Dyshidrotic Dermatitis (Pompholyx) Unknown; sweat gland dysfunction Palms, soles Deep vesicles, intense itching Stress, nickel, heat Potent topical steroids Consider nickel sensitivity
Perioral Dermatitis Steroid-induced or cosmetic-related Around mouth, nose Papules, pustules, sparing vermilion border Topical steroids, cosmetics Stop steroids, topical antibiotics Steroid withdrawal may worsen symptoms initially
Photodermatitis UV-induced or photo-drug interaction Sun-exposed areas Erythema, blistering Sunlight, photosensitizing drugs Sun avoidance, topical steroids Review medication list carefully
Neurodermatitis (Lichen Simplex Chronicus) Chronic scratching cycle Neck, wrists, ankles Thickened plaques, hyperpigmentation Stress, anxiety Potent topical steroids Address behavioral triggers
Infectious Dermatitis Secondary bacterial or fungal infection Variable Oozing, crusting, worsening inflammation Skin barrier disruption Antimicrobials + anti-inflammatory therapy Treat infection first, then inflammation

High-Yield Pharmacist Pearls

  • Pruritus control is central to management (topicals, antihistamines if needed)
  • Avoid long-term high-potency topical steroids, especially on face and intertriginous areas
  • Consider secondary infection if dermatitis worsens despite treatment
  • Counsel on proper topical application (fingertip unit method)
  • Review medication lists for drug-induced or photo-induced dermatitis
  • Emollients are not optional—they are therapeutic
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