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Eczema craquelé
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Eczema craquelé

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Contributors: Noah Craft MD, PhD, Lindy P. Fox MD, Lowell A. Goldsmith MD, MPH
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Synopsis

Eczema craquelé is also known as winter itch, asteatotic eczema, xerotic eczema, and desiccation dermatitis. These entities represent the extreme end of the spectrum of xerosis.

Xerosis is the predisposing factor to the development of eczema craquelé. It refers to a condition of rough, dry skin texture with fine scale and occasionally fine fissuring. It is often pruritic. The pathogenesis involves a decrease in the amount of lipids in the stratum corneum and a deficiency in the water-binding capacity of this layer. The most common cause of xerosis is aging; however, it can be associated with a number of environmental factors and/or disease states, such as low humidity, frequent bathing, harsh soaps, congenital and acquired ichthyoses, atopic dermatitis, hypothyroidism, Down syndrome, renal failure, malnutrition and malabsorptive states, human immunodeficiency virus (HIV) infection, lymphoma, liver disease, Sjögren syndrome, carcinomatosis, and certain drugs. Asteatotic dermatitis is a rare presentation of zinc deficiency.

Eczema craquelé begins as dry skin that progresses to superficially fissured, inflamed, and sometimes crusted dermatitis. A generalized dermatitis can develop. The condition is seen mostly in elderly individuals. This may be due to decreased sebaceous / sweat gland activity and keratin synthesis in elderly persons, as well as a host of other factors such as malnutrition, drugs, and underlying illnesses. The condition is exacerbated by low humidity and frequent bathing without moisturizing. Pruritus is frequent, and painful lesions can occur if the fissures are deep.

Codes

ICD10CM:
L85.3 – Xerosis cutis

SNOMEDCT:
201077008 – Eczema craquele

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

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: 10/03/2019
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Eczema craquelé
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Eczema craquelé : Dry skin, Fine skin fissures, Ichthyotic scaly plaque, Lower leg, Pruritus
Clinical image of Eczema craquelé
Polygonal and angulated cracks, each flanked by fine white scales, on the shin.
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