07/01/2025
Derm Index: What You Should Know About Asteatotic Eczema
Asteatotic eczema, also referred to as xerotic eczema or eczema craquelé, is a form of eczema characterized by excessively dry, itchy, and cracked skin. It is a common condition among the elderly but can also affect individuals in their 20s. This dermatitis is typically manifested by red, flaky patches of skin that are particularly prevalent on the lower legs, as well as the thighs, chest, and arms.
Asteatotic eczema is most frequently seen in the winter months, especially in areas with cold, dry climates where indoor heating significantly reduces ambient humidity. This seasonality is especially notable in the northern United States, where the lack of humidity during the winter exacerbates the condition. Notably, patients may experience symptom relief in warmer, more humid climates, which suggests a relationship between environmental humidity and the condition’s severity.
Pathophysiology
The pathophysiology of asteatotic eczema is largely attributed to a disruption of the skin barrier function. The stratum corneum, the outermost layer of the skin, becomes compromised due to excessive dryness, leading to cracks and fissures. This disruption facilitates water loss and makes the skin more vulnerable to irritants and allergens. As a result, patients may experience itching (pruritus) and inflammation, which can further damage the skin’s protective barrier, leading to a cycle of worsening dryness and irritation. In some cases, atopic dermatitis (eczema) can be exacerbated by the inflammatory response to environmental and intrinsic factors.
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