Asteatosis

Erythematous, scaly lesions with double-edged borders had been present on a 14-year-old boy's left upper arm and lower legs for about a year. The lesions were occasionally pruritic, and some resembled ringworm. At times, fine yellow crusting suggestive of impetigo was present. The boy took very hot baths and showers.

Robert P. Blereau, MD, of Morgan City, La, reports that the results of a potassium hydroxide evaluation and culture were negative for fungal elements. Treatment with oral cephalexin was ineffective. Asteatosis was diagnosed after dermatologic consultation.

Asteatosis (asteatotic eczema or eczema craquel) is associated with excessive drying of the skin and may be exacerbated by cold weather, hot baths and showers, and low humidity. This condition is very common, especially in the elderly. The lesions may affect any area, particularly the legs. Xerosis may also accentuate skin lines.¹

Treatment of asteatotic eczema includes wet compresses, oral antibiotics for any superficial infection, topical corticosteroids and, most important, lubricants and moisturizers. This patient was told to avoid excessively hot showers and baths and to use topical corticosteroids, moisturizing soaps, and lubricants. His condition promptly improved with treatment.

REFERENCE:1. Habif TP. Clinical Dermatology. 3rd ed. St Louis: Mosby; 1996:64.