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Chronic eczematous eruptions of the aged
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Chronic eczematous eruptions of the aged

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Contributors: Erika M. Summers MD, Richard D. Sontheimer MD, Lowell A. Goldsmith MD, MPH
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Synopsis

Chronic eczematous eruptions of the aging (CEEA), also known as chronic eczematous eruptions of the elderly, is a widespread eczematous dermatitis occurring in individuals of at least 50 years of age; it has multiple potential underlying causes. CEEA is often accompanied by refractory and chronic pruritus that is challenging to manage. Often, the inability to determine the underlying etiology of CEEA in a particular individual adds to the difficulty in management.

Chronic prescription drug use may be a common cause of CEEA. This is especially relevant in the aging population, as medication use increases with age. Retrospective case control studies have shown that calcium channel blockers and possibly hydrochlorothiazide are associated with CEEA more than other medication classes.

The case definition of CEEA includes the following:
  • Age 50 or older
  • At least 2 months duration of the eruption
  • A symmetrical eczematous eruption (ie, pruritic, erythematous, scaly, subacute, or chronic dermatitis lesions) involving the trunk and extremities (with proclivity for extensor aspects of the extremities)
  • Routine skin biopsy consistent with an eczematous eruption (the presence of spongiotic dermatitis in the inflammatory infiltrate and/or the presence of overlapping elements of other inflammatory histologic patterns)
  • No prior history of an underlying dermatitis that would be compatible with the eruption (ie, psoriasis, atopic dermatitis)

Codes

ICD10CM:
L30.8 – Other specified dermatitis

SNOMEDCT:
400051008 – Senile asteatotic eczema

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Common pitfalls in attempting to discern the underlying etiology include lack of a thorough medication history, evaluation of contact exposures, and histologic evaluation. If necessary, medication lists should be confirmed with a patient's pharmacy.

The most common etiologic causes include:
Of note, an underlying cause for CEEA cannot be determined in approximately half of all patients.

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 07/12/2017
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Chronic eczematous eruptions of the aged
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Chronic eczematous eruptions of the aged : Erythema, Fine scaly plaque, Symmetric extremities, Trunk, Widespread, Pruritus
Clinical image of Chronic eczematous eruptions of the aged
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