Infectious eczematoid dermatitis: a comprehensive review

Abstract

Infectious eczematoid dermatitis (IED) is characterized by an acute eczematous eruption triggered by purulent discharge from a primary infected site. Alcohol consumption, cigarette smoking and occupations with higher incidences of contact dermatitis portend increased risk for IED. Staphylococcus aureus is the most commonly cultured microbe from affected skin, with Streptococcus species the second most. Patients are first evident with peripherally spreading vesicles and pustules radiating from an infected site. Older areas of involvement become crusty, scaly and erythematous. Diagnosis is clinical. Other eczematous rashes, including autoeczemitization and contact dermatitis, should be on the differential diagnosis list. The treatment centres on topical antibiotics and soaks. Prognosis has improved since the advent of antibiotics. However, cases with multiple relapses and poor response to therapy are still observed.

Interdigital Tinea: The Forerunner of Infectious Eczematoid Dermatitis

“…This condition is defined as an acute, eczematous eruption that occurs secondary to autosensitization to purulent drainage from a primary infected site. 7 In a 1902 study of 1200 new patients to an outpatient dermatology clinic, Engman reported that 35, or 2.9%, had presentations consistent with IED. 8 A study at the Mayo Clinic examining inpatient dermatology admissions from 2000-2010 reported similar results, finding that 2.9% of 2216 admissions were due to IED.…”

“…9 IED is believed to develop when purulent drainage from a primary infection causes autosensitization, with hypersensitivity developing as bacterial products act as haptens and stimulate an immune response. 7 Staphylococcal and/or Streptococcal species are most commonly associated with IED. 10 In this case, interdigital tinea pedis, and associated bacterial infection, flourished in the warm, moist environment of the patient's wet boots over two days.…”

“…11 IED is a localized process that occurs adjacent to and surrounding the primary infectious locus. 7 IED often initially presents as a plaque with associated vesicles and pustules surrounding a central source of infectious drainage.…”

“…The lesion may spread peripherally, and older areas are distinguished by oozing, erythema, scaling, and crusting. 7 Alternatively, patients may present with oozing, erythema, crusting, and scaling that spreads peripherally from the central infectious source but with no evidence of vesicles or pustules. 8 The patient from case 2 presented as the latter type.…”

Phototherapy in the treatment of microbial eczema

“…Микробная экзема представляет собой экзематозный процесс, обусловленный сенсибилизацией кожи к антигенам пиококковой флоры и дрожжевых грибов [13]. Основным клиническим проявлением дерматоза является возникновение островоспалительных везикулезных высыпаний в ответ на антигенную стимуляцию из инфекционного очага [14]. Первый синоним болезни был придуман Engman в 1902 году, который назвал патологию «стафилогенный экзематоидный дерматит» [15].…”