Impetiginized Dyshidrotic Eczema

Georgi Tchernev; Matteo Zanardelli; Cristiana Voicu; Ilko Bakardzhiev; Torello Lotti; Jacopo Lotti; Katlein FranÃ§a; Atanas Batashki; Uwe Wollina

doi:10.3889/oamjms.2017.081

Authors

Georgi Tchernev Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, and Onkoderma Polyclinic for Dermatology and Dermatologic Surgery, Sofia
Matteo Zanardelli Pharmacology, Toxicology and Innovative Treatments, Rome
Cristiana Voicu Dermatology Department, Polisano Clinic, 26Z Timisoara Blvd, Bucharest
Ilko Bakardzhiev Medical College, Medical University of Varna, Varna 9000
Torello Lotti Department of Dermatology, University of Rome â€œG. Marconiâ€; Rome, Italy; Department of Biotechnology, Delft University of Technology, 2628 BC, Delft
Jacopo Lotti Department of Nuclear, Subnuclear and Radiation Physics, University of Rome "G. Marconi", Rome
Katlein FranÃ§a Institute for Bioethics & Health Policy; Department of Dermatology & Cutaneous Surgery; Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine - Miami, FL
Atanas Batashki Abdominal and Thoracic Surgery, Department of Special Surgery, Medical University of Plovdiv, bul. "Peshtersko shose" Nr 66, 4000, Plovdiv
Uwe Wollina Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden

DOI:

https://doi.org/10.3889/oamjms.2017.081

Keywords:

hand dermatitis, superinfections, St. aureus, clobetasol, skin barrier

Abstract

A 16 years old female patient, affected by atopic dermatitis and rhinoconjunctivitis allergica since childhood, requested a dermatologic consultation for lesions which had appeared after 3 months of local treatment with clobethasole propionate. The histological analysis confirmed the diagnosis of dyshidrotic eczema and the microbiological smears demonstrated a significant infection with Staphylococcus aureus. The risk of developing corticosteroidsâ€™ side-effects depends on the potency of the product, extended period of use and the volume of product applied. Clobetasol propionate is a group I- highly potent corticosteroid, which should be used for a maximum period of 2 weeks. Several authors have found that this agent has cumulative depot effect, persisting in the epidermis for 4 days after only one application. Taking together these observations, sustained by the clinical case presented above, we can conclude that the infectious risks associated with topical corticosteroid treatment must not be neglected, particularly since treated patients are fragile, and frequently have multiple well-known risk factors.

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