Dermatitis update: clinical manifestations, pathogenesis and current therapeutic approaches

Abstract

Dermatitis affects up to 10 % of the population, and yet its nomenclature still remains inconsistent. Classifications can be made according to morphology, localization, triggers, kinetics, or pathophysiology. The eczematous inflammatory reaction involves the migration of activated T-lymphocytes into the epidermis (epidermotropismus) and pathological changes to the epidermal keratinocytes occur, with spongiosis, acanthosis, and parakeratosis. Dermatitis is characterized by a polymorphous clinical picture. Contact dermatitis (toxic irritant and allergic) and atopic dermatitis (neurodermatitis) account for the majority of dermatitis cases. Seborrheic dermatitis and nummular (dysregulatory microbial) dermatitis are also common. A qualified overall assessment of the targeted patient history and clinical picture are crucial to correctly diagnosing the type of dermatitis. This is followed by further diagnostics to confirm the dermatitis type, identify potential triggers, and exclude differential diagnoses. Since most forms of dermatitis can be caused by allergy, a qualified allergy diagnostic work-up is often necessary. Dermatitis management primarily comprises avoiding/dealing with the causes, alongside symptomatic treatment. In terms of treatment, local and systemic therapies with an anti-inflammatory, immunosuppressant, antipruritic, hydrating, keratolytic, antiproliferative, antimicrobial, antifungal, or dehydrating/astringent effect are available.