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Causes of Dermatitis
List of causes of Dermatitis
Following is a list of causes or underlying conditions (see also Misdiagnosis of underlying causes of Dermatitis) that could possibly cause Dermatitis includes:
- Numerous underlying causes are possible
- Certain infections (see Infection)
- Certain toxins or chemicals
- Allergic reaction
More causes: see full list of causes for Dermatitis
Causes of Dermatitis: Online Medical Books
16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the causes of Dermatitis.
Dry Skin (Xerosis):
Differential Diagnosis
(In a Page: Signs and Symptoms)
- Dry skin is a very common problem
–Low humidity and cold temperatures make winter xerosis and “winter itch” common complaints
–Mild xerosis can cause impaired skin barrier function and allow irritants and allergens to more easily affect the skin
–Most common on the legs, but often affecting the entire skin surface
–Can present with severe pruritus without much evidence of a rash - Severe xerosis is common in the elderly, and can cause eczema craquelé
–Patient's legs often have scale that resembles cracked porcelain
–Secondary erythema and excoriations occur because of the persistent itch - Ichthyoses vulgaris
–Very common cause of dry skin
–A genetic defect in skin barrier function, leading to a higher risk of atopic dermatitis
–Patients often have hyperlinearity of their palmar skin and xerotic fish scale on their legs - Many genetic conditions, such as the large family of ichthyoses (including X-linked ichthyoses, Netherton's disease), lead to severely dry skin in association with other systemic manifestations
- Hypothyroidism and hyperthyroidism can also cause marked xerosis and/or itch
- Anemia
- There is an uncommon association between lymphoma and marked xerosis
- HIV
- Sarcoidosis
- Liver and biliary disease, and renal insufficiency, are commonly associated with xerosis and marked pruritus
- Diabetes mellitus
- Medications (e.g., niacinamide)
- Atopic dermatitis
Genital Skin Lesions:
Differential Diagnosis
(In a Page: Signs and Symptoms)
-
Herpes simplex virus (HSV-1 and HSV-2) is the most common cause of genital lesions in the U.S.
–Presents with prodromal tingling and genital discomfort before lesions
–Lesions are always painful and appear as grouped vesicles on an erythematous base -
Condyloma acuminatum (“warts,” HPV)
–Etiologic agent is human papilloma virus
–Lesions usually painless and pearly with a smooth surface but may be filiform, fungating, and lobulated
–Inguinal erythema with itch or tenderness
–Always spares the scrotum
–Inguinal erythema with itch or tenderness
–Often very red with satellite lesions
–Frequently involves the labia or scrotum
–Primary stage: Painless solitary ulcer (chancre) on labia, penis, or oral mucosa that heals in 2–3 weeks
–Secondary stage: Condyloma lata (moist hypertrophic papules on genital and oral regions)
–Tertiary stage: Cardiac, neurologic, and other systemic effects
-
Molluscum contagiosum
–Multiple, very small, painless, flesh-colored nodules with umbilicated centers
-
Chancroid
–Etiologic agent is Haemophilus ducreyi
–Painful, solitary, and erythematous lesions
–May present with dyspareunia and/or dysuria
–Oral and genital ulcers, retinitis, uveitis
Skin Pigmentation (Decreased):
Differential Diagnosis
(In a Page: Signs and Symptoms)
- Vitiligo
–Affects 1% of the population
–Begins as a focal or diffuse (more common) hypopigmented patch that progresses to total loss of pigmentation of the affected skin (chalk white)
–Usually symmetric; often tops of hands, perioral, periorbital skin, knees, elbows
-
Pityriasis alba
–Very common, especially in black children
–Less distinct borders than in vitiligo, does not result in complete depigmentation
–Plaques may appear lighter than surrounding skin and may be scaly
–Often secondary to mild inflammation, such as tinea versicolor or atopic eczema
–Completely reversible and does not cause permanent hypopigmentation
-
Piebaldism
–Congenital, permanent, and irreversible
–Newborns often have a patch of white scalp hair and depigmented patches on the trunk with normally pigmented patches within these larger depigmented areas -
Chemical leukoderma (depigmentation)
–May be caused by phenols, germicides, and many other caustic chemicals
–Results in confetti-like macules of depigmentation in exposed skin- Albinism
–Congenital
–Disorder of melanin synthesis with several phenotypes, ranging from complete lack of pigmentation (white hair and translucent or “red” iris) to the more common diffuse hypopigmentation or “yellow” albinism that is prevalent in the black population
–Affects the skin, hair, and eyes
–Photophobia, decreased visual acuity, strabismus, and risk of skin cancer are the main problems faced by these patients
- Congenital birthmarks (e.g., nevus anemicus, nevus depigmentosis) are isolated patches of hypo- or depigmentation that remain unchanged over time
- Tuberous sclerosis is an inherited systemic disorder that results in hypopigmented macules in the shape of an “ash leaf ” on the trunk, and confetti-type depigmented macules on the arms/legs
- Albinism
Skin turgor, decreased:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
Cholera
Cholera is characterized by abrupt watery diarrhea and vomiting, which leads to severe water and electrolyte loss. These imbalances cause the following symptoms: decreased skin turgor, thirst, weakness, muscle cramps, oliguria, tachycardia, and hypotension. Without treatment, death can occur within hours.
Dehydration
Decreased skin turgor commonly occurs with moderate to severe dehydration. Associated findings include dry oral mucosa, decreased perspiration, resting tachycardia, orthostatic hypotension, a dry and furrowed tongue, increased thirst, weight loss, oliguria, a fever, and fatigue. As dehydration worsens, other findings include enophthalmos, lethargy, weakness, confusion, delirium or obtundation, anuria, and shock. Hypotension persists even when the patient lies down.
Skin, clammy:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
Anxiety
An acute anxiety attack commonly produces cold, clammy skin on the forehead, palms, and soles. Other features include pallor, a dry mouth, tachycardia or bradycardia, palpitations, and hypertension or hypotension. The patient may also develop tremors, breathlessness, a headache, muscle tension, nausea, vomiting, abdominal distention, diarrhea, increased urination, and sharp chest pain.
Arrhythmias
Cardiac arrhythmias may produce generalized cool, clammy skin along with mental status changes, dizziness, and hypotension.
Cardiogenic shock
Generalized cool, moist, pale skin accompanies confusion, restlessness, hypotension, tachycardia, tachypnea, narrowing pulse pressure, cyanosis, and oliguria.
Heat exhaustion
In the acute stage of heat exhaustion, generalized cold, clammy skin accompanies an ashen appearance, a headache, confusion, syncope, giddiness and, possibly, a subnormal temperature, with mild heat exhaustion. The patient may exhibit a rapid and thready pulse, nausea, vomiting, tachypnea, oliguria, thirst, muscle cramps, and hypotension.
Hypoglycemia (acute)
Generalized cool, clammy skin or diaphoresis may accompany irritability, tremors, palpitations, hunger, a headache, tachycardia, and anxiety. Central nervous system disturbances include blurred vision, diplopia, confusion, motor weakness, hemiplegia, and coma. These signs and symptoms typically resolve after the patient is given glucose.
Hypovolemic shock
With hypovolemic shock, generalized pale, cold, clammy skin accompanies a subnormal body temperature, hypotension with narrowing pulse pressure, tachycardia, tachypnea, and a rapid, thready pulse. Other findings are flat neck veins, an increased capillary refill time, decreased urine output, confusion, and a decreased level of consciousness.
Septic shock
The cold shock stage causes generalized cold, clammy skin. Associated findings include a rapid and thready pulse, severe hypotension, persistent oliguria or anuria, and respiratory failure.
Skin, mottled:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
Acrocyanosis
With the rare disorder acrocyanosis, anxiety or exposure to cold can cause vasospasm in small cutaneous arterioles. This results in persistent symmetrical blue and red mottling of the affected hands, feet, and nose.
Arterial occlusion (acute)
Initial signs of acute arterial occlusion include temperature and color changes. Pallor may change to blotchy cyanosis and livedo reticularis. Color and temperature demarcation develop at the level of obstruction. Other effects include sudden onset of pain in the extremity and, possibly, paresthesia, paresis, and a sensation of cold in the affected area. Examination reveals diminished or absent pulses, cool extremities, an increased capillary refill time, pallor, and diminished reflexes.
Arteriosclerosis obliterans
Atherosclerotic buildup narrows intra-arterial lumina, resulting in reduced blood flow through the affected artery. Obstructed blood flow to the extremities (most commonly the legs) produces such peripheral signs and symptoms as leg pallor, cyanosis, blotchy erythema, and livedo reticularis. Related findings include intermittent claudication (most common symptom), diminished or absent pedal pulses, and leg coolness. Other symptoms include coldness and paresthesia.
Buerger’s disease
Buerger’s disease, a form of vasculitis, produces unilateral or asymmetrical color changes and mottling, particularly livedo networking in the lower extremities. It also typically causes intermittent claudication and erythema along extremity blood vessels. During exposure to cold, the feet are cold, cyanotic, and numb; later they’re hot, red, and tingling. Other findings include impaired peripheral pulses and peripheral neuropathy. Buerger’s disease is typically exacerbated by smoking.
Cryoglobulinemia
Cryoglobulinemia is a necrotizing disorder that causes patchy livedo reticularis, petechiae, and ecchymoses. Other findings include a fever, chills, urticaria, melena, skin ulcers, epistaxis, Raynaud’s phenomenon, eye hemorrhages, hematuria, and gangrene.
Hypovolemic shock
Vasoconstriction from shock commonly produces skin mottling, initially in the knees and elbows. As shock worsens, mottling becomes generalized. Early signs include a sudden onset of pallor, cool skin, restlessness, thirst, tachypnea, and slight tachycardia. As shock progresses, associated findings include cool, clammy skin; a rapid, thready pulse; hypotension; narrowed pulse pressure; decreased urine output; subnormal temperature; confusion; and a decreased level of consciousness.
Livedo reticularis (idiopathic or primary)
Symmetrical, diffuse mottling can involve the hands, feet, arms, legs, buttocks, and trunk. Initially, networking is intermittent and most pronounced on exposure to cold or stress; eventually, mottling persists even with warming.
Periarteritis nodosa
Skin findings in periarteritis nodosa include asymmetrical, patchy livedo reticularis, palpable nodules along the path of medium-sized arteries, erythema, purpura, muscle wasting, ulcers, gangrene, peripheral neuropathy, a fever, weight loss, and malaise.
Polycythemia vera
Polycythemia vera is a hematologic disorder that produces livedo reticularis, hemangiomas, purpura, rubor, ulcerative nodules, and scleroderma-like lesions. Other symptoms include a headache, a vague feeling of fullness in the head, dizziness, vertigo, vision disturbances, dyspnea, and aquagenic pruritus.
Systemic lupus erythematosus (SLE)
SLE is a connective tissue disorder that can cause livedo reticularis, most commonly on the outer arms. Other signs and symptoms include a butterfly rash, nondeforming joint pain and stiffness, photosensitivity, Raynaud’s phenomenon, patchy alopecia, seizures, a fever, anorexia, weight loss, lymphadenopathy, and emotional lability.
Other causes
Immobility
Prolonged immobility may cause bluish mottling, most noticeably in dependent extremities.
Thermal exposure
Prolonged thermal exposure, as from a heating pad or hot water bottle, may cause erythema Ab Igne — a localized, reticulated, brown-to-red mottling.
Skin, scaly:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
Bowen’s disease
Bowen’s disease is a common form of intraepidermal carcinoma that causes painless, erythematous plaques that are raised and indurated with a thick, hyperkeratotic scale and, possibly, ulcerated centers.
Dermatitis
Exfoliative dermatitis begins with rapidly developing generalized erythema. Desquamation with fine scales or thick sheets of all or most of the skin surface may cause life-threatening hypothermia. Other possible complications include cardiac output failure and septicemia. Systemic signs and symptoms include a low-grade fever, chills, malaise, lymphadenopathy, and gynecomastia.
With nummular dermatitis, round, pustular lesions commonly ooze purulent exudate, itch severely, and rapidly become encrusted and scaly. Lesions appear on the extensor surfaces of the limbs, posterior trunk, and buttocks.
Seborrheic dermatitis begins with erythematous, scaly papules that progress to larger, dry or moist, greasy scales with yellowish crusts. This disorder primarily involves the center of the face, the chest and scalp and, possibly, the genitalia, axillae, and perianal regions. Pruritus occurs with scaling.
Dermatophytosis
Tinea capitis produces lesions with reddened, slightly elevated borders and a central area of dense scaling; these lesions may become inflamed and pus-filled (kerions). Patchy alopecia and itching may also occur. Tinea pedis causes scaling and blisters between the toes. The squamous type produces diffuse, fine, branlike scales. Adherent and silvery white, they’re most prominent in skin creases and may affect the entire dorsum of the foot. Tinea corporis produces crusty lesions. As they enlarge, their centers heal, causing the classic ringworm shape.
Lymphoma
Hodgkin’s disease and non-Hodgkin’s lymphoma commonly cause scaly rashes. Hodgkin’s disease may cause pruritic scaling dermatitis that begins in the legs and spreads to the entire body. Remissions and recurrences are common. Small nodules and diffuse pigmentation are related signs. This disease typically produces painless enlargement of the peripheral lymph nodes. Other signs and symptoms include a fever, fatigue, weight loss, malaise, and hepatosplenomegaly.
Non-Hodgkin’s lymphoma initially produces erythematous patches with some scaling that later become interspersed with nodules. Pruritus and discomfort are common; later, tumors and ulcers form. Progression produces nontender lymphadenopathy.
Parapsoriasis (chronic)
Parapsoriasis produces small or moderate-sized maculopapular, erythematous eruptions, with a thin, adherent scale on the trunk, hands, and feet. Removal of the scale reveals a shiny brown surface.
Pityriasis
Pityriasis rosea, an acute, benign, and self-limiting disorder, produces widespread scales. It begins with an erythematous, raised, oval herald patch anywhere on the body. A few days or weeks later, yellow-tan or erythematous patches with scaly edges erupt on the trunk and limbs and sometimes on the face, hands, and feet. Pruritus also occurs.
Pityriasis rubra pilaris, an uncommon disorder, initially produces seborrheic scaling on the scalp, progressing to the face and ears. Later, scaly red patches develop on the palms and soles, becoming diffuse, thick, fissured, hyperkeratotic, and painful. Lesions also appear on the hands, fingers, wrists, and forearms and then on wide areas of the trunk, neck, and limbs.
Psoriasis
Silvery white, micaceous scales cover erythematous plaques that have sharply defined borders. Psoriasis usually appears on the scalp, chest, elbows, knees, back, buttocks, and genitalia. Associated signs and symptoms include nail pitting, pruritus, arthritis, and sometimes pain from dry, cracked, encrusted lesions.
Systemic lupus erythematosus (SLE)
SLE produces a bright-red maculopapular eruption, sometimes with scaling. Patches are sharply defined and involve the nose and malar regions of the face in a butterfly pattern — a primary sign. Similar characteristic rashes appear on other body surfaces; scaling occurs along the lower lip or anterior hair line. Other primary signs and symptoms include photosensitivity and joint pain and stiffness. Vasculitis (leading to infarctive lesions, necrotic leg ulcers, or digital gangrene), Raynaud’s phenomenon, patchy alopecia, and mucous membrane ulcers can also occur.
Tinea versicolor
Tinea versicolor is a benign fungal skin infection that typically produces macular hypopigmented, fawn-colored, or brown patches of varying sizes and shapes. All are slightly scaly. Lesions commonly affect the upper trunk, arms, and lower abdomen; sometimes the neck; and, rarely, the face.
Other causes
Drugs
Many drugs — including penicillins, sulfonamides, barbiturates, quinidine, diazepam, phenytoin, and isoniazid — can produce scaling patches.
Dermatitis:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
The cause of atopic dermatitis is unknown, but a genetic predisposition may be exacerbated by such factors as food allergies, infections, irritating chemicals, temperature and humidity, and emotions. Approximately 10% of childhood cases are due to allergy to certain foods, particularly eggs, peanuts, milk, fish, soy, and wheat. Atopic dermatitis tends to flare up in response to extremes in temperature and humidity. Other causes of flare-ups are sweating and psychological stress.
An important secondary cause of atopic dermatitis is irritation, which seems to change the epidermal structure, allowing immunoglobulin (Ig) E activity to increase. Consequently, chronic skin irritation usually continues even after exposure to the allergen has ended or after the irritation has been systemically controlled.
Atopic dermatitis is most common in infants, usually developing between ages 1 month and 1 year, commonly in those with strong family histories of atopic disease. At least half of those cases clear by age 36 months. These children often acquire other atopic disorders as they grow older. Typically, this form of dermatitis flares and subsides repeatedly before finally resolving during adolescence. However, it can persist into adulthood. In adults, it’s generally chronic or recurring.
Atopic dermatitis:
Causes
(Professional Guide to Diseases (Eighth Edition))
The cause of atopic dermatitis is still unknown. However, several theories attempt to explain its pathogenesis. One theory suggests an underlying metabolically or biochemically induced skin disorder that’s genetically linked to elevated serum immunoglobulin (Ig) E levels. Another theory suggests defective T-cell function.
Exacerbating factors of atopic dermatitis include irritants, infections (commonly caused by Staphylococcus aureus), and some allergens. Although no reliable link exists between atopic dermatitis and exposure to inhalant allergens (such as house dust and animal dander), exposure to food allergens (such as soybeans, fish, or nuts) may coincide with flare-ups of atopic dermatitis.
Staphylococcal scalded skin syndrome:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
The causative organism in SSSS is group 2 Staphylococcus aureus, primarily phage type 71, which produces exotoxins that cause detachment of the epidermis. Predisposing factors may include impaired immunity and renal insufficiency — present to some extent in the normal neonate because of immature development of these systems.
SSSS is most prevalent in infants age 1 to 3 months but may develop in children. It’s uncommon in adults.
Skin turgor, decreased:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Cholera
This infection is characterized by abrupt watery diarrhea and vomiting, which leads to severe water and electrolyte loss. These imbalances cause the following symptoms: decreased skin turgor, thirst, weakness, muscle cramps, oliguria, tachycardia, and hypotension. Without treatment, death can occur within hours.
Dehydration
Decreased skin turgor commonly occurs with moderate to severe dehydration. Associated findings include dry oral mucosa, decreased perspiration, resting tachycardia, orthostatic hypotension, dry and furrowed tongue, increased thirst, weight loss, oliguria, fever, and fatigue. As dehydration worsens, other findings include enophthalmos, lethargy, weakness, confusion, delirium or obtundation, anuria, and shock. Hypotension persists even when the patient lies down.
Skin, bronze:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Adrenal hyperplasia
The skin assumes a dark bronze tone within a few months. Other findings include visual field deficits and headache (from an expanding pituitary lesion), and signs of masculinization in females.
Biliary cirrhosis
This disorder causes bronze skin from melanosis of exposed areas of jaundiced skin: eyelids, palms, neck, and chest or back. The patient may also experience generalized pruritus, weakness, fatigue, jaundice, dark urine, pale stools with steatorrhea, decreased appetite with weight loss, and hepatomegaly.
Chronic renal failure
The skin becomes pallid, yellowish bronze, dry, and scaly. Other findings include ammonia breath odor, oliguria, fatigue, decreased mental acuity, seizures, muscle cramps, peripheral neuropathy, bleeding tendencies, pruritus and, occasionally, uremic frost and hypertension.
Hemochromatosis
An early sign is progressive, generalized bronzing accentuated by metallic gray-bronze skin on sun-exposed areas, genitalia, and scars. Mucous membranes are affected less often. Early associated effects include weakness, lethargy, weight loss, abdominal pain, loss of libido, polydipsia, and polyuria.
Malnutrition
As weight loss depletes body nutrients, bronzing develops along with apathy, lethargy, anorexia, weakness, and slow pulse and respiratory rates. Patients may develop paresthesia in the extremities; dull, sparse, dry hair; brittle nails; dark, swollen cheeks; dry, flaky skin; red, swollen lips; muscle wasting; and gonadal atrophy in males.
Primary adrenal insufficiency
Bronze skin is a classic sign. Other findings include axillary and pubic hair loss, vitiligo, progressive fatigue, weakness, anorexia, nausea and vomiting, weight loss, orthostatic hypotension, weak and irregular pulse, abdominal pain, irritability, diarrhea or constipation, amenorrhea, and syncope.
Wilson’s disease
Kayser-Fleischer rings—rusty brown rings of pigment around the corneas—characterize this disease, which may cause skin bronzing. Other effects include incoordination, dysarthria, chorea, ataxia, muscle spasms and rigidity, abdominal distress, fatigue, personality changes, hypotension, syncope, and seizures.
Other causes
Drugs
Prolonged therapy with high doses of a phenothiazine may cause gradual bronzing of the skin.
Skin, clammy:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Anxiety
An acute anxiety attack commonly produces cold, clammy skin on the forehead, palms, and soles. Other features include pallor, dry mouth, tachycardia or bradycardia, palpitations, and hypertension or hypotension. The patient may also develop tremors, breathlessness, headache, muscle tension, nausea, vomiting, abdominal distention, diarrhea, increased urination, and sharp chest pain.
Arrhythmias
Cardiac arrhythmias may produce generalized cool, clammy skin along with mental status changes, dizziness, and hypotension.
Cardiogenic shock
Generalized cool, moist, pale skin accompanies confusion, restlessness, hypotension, tachycardia, tachypnea, narrowing pulse pressure, cyanosis, and oliguria.
Heat exhaustion
In the acute stage of heat exhaustion, generalized cold, clammy skin accompanies an ashen appearance, headache, confusion, syncope, giddiness and, possibly, a subnormal temperature, with mild heat exhaustion. The patient may exhibit a rapid and thready pulse, nausea, vomiting, tachypnea, oliguria, thirst, muscle cramps, and hypotension.
Hypoglycemia (acute)
Generalized cool, clammy skin or diaphoresis may accompany irritability, tremors, palpitations, hunger, headache, tachycardia, and anxiety. Central nervous system disturbances include blurred vision, diplopia, confusion, motor weakness, hemiplegia, and coma. These signs and symptoms typically resolve after the patient is given glucose.
Hypovolemic shock
With this common form of shock, generalized pale, cold, clammy skin accompanies subnormal body temperature, hypotension with narrowing pulse pressure, tachycardia, tachypnea, and rapid, thready pulse. Other findings are flat neck veins, increased capillary refill time, decreased urine output, confusion, and decreased level of consciousness.
Septic shock
The cold shock stage causes generalized cold, clammy skin. Associated findings include rapid and thready pulse, severe hypotension, persistent oliguria or anuria, and respiratory failure.
Skin, mottled:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Acrocyanosis
With this rare disorder, anxiety or exposure to cold can cause vasospasm in small cutaneous arterioles. This results in persistent symmetrical blue and red mottling of the affected hands, feet, and nose.
Arterial occlusion (acute)
Initial signs include temperature and color changes. Pallor may change to blotchy cyanosis and livedo reticularis. Color and temperature demarcation develop at the level of obstruction. Other effects include sudden onset of pain in the extremity and possibly paresthesia, paresis, and a sensation of cold in the affected area. Examination reveals diminished or absent pulses, cool extremities, increased capillary refill time, pallor, and diminished reflexes.
Arteriosclerosis obliterans
Atherosclerotic buildup narrows intra-arterial lumina, resulting in reduced blood flow through the affected artery. Obstructed blood flow to the extremities (most commonly the lower) produces such peripheral signs and symptoms as leg pallor, cyanosis, blotchy erythema, and livedo reticularis. Related findings include intermittent claudication (most common symptom), diminished or absent pedal pulses, and leg coolness. Other symptoms include coldness and paresthesia.
Buerger’s disease
This form of vasculitis produces unilateral or asymmetrical color changes and mottling, particularly livedo networking in the lower extremities. It also typically causes intermittent claudication and erythema along extremity blood vessels. During exposure to cold, the feet are cold, cyanotic, and numb; later they’re hot, red, and tingling. Other findings include impaired peripheral pulses and peripheral neuropathy. Buerger’s disease is typically exacerbated by smoking.
Cryoglobulinemia
This necrotizing disorder causes patchy livedo reticularis, petechiae, and ecchymoses. Other findings include fever, chills, urticaria, melena, skin ulcers, epistaxis, Raynaud’s phenomenon, eye hemorrhages, hematuria, and gangrene.
Hypovolemic shock
Vasoconstriction from shock commonly produces skin mottling, initially in the knees and elbows. As shock worsens, mottling becomes generalized. Early signs include sudden onset of pallor, cool skin, restlessness, thirst, tachypnea, and slight tachycardia. As shock progresses, associated findings include cool, clammy skin; rapid, thready pulse; hypotension; narrowed pulse pressure; decreased urine output; subnormal temperature; confusion; and decreased level of consciousness.
Livedo reticularis (idiopathic or primary)
Symmetrical, diffuse mottling can involve the hands, feet, arms, legs, buttocks, and trunk. Initially, networking is intermittent and most pronounced on exposure to cold or stress; eventually, mottling persists even with warming.
Periarteritis nodosa
Skin findings include asymmetrical, patchy livedo reticularis, palpable nodules along the path of medium-sized arteries, erythema, purpura, muscle wasting, ulcers, gangrene, peripheral neuropathy, fever, weight loss, and malaise.
Polycythemia vera
This hematologic disorder produces livedo reticularis, hemangiomas, purpura, rubor, ulcerative nodules, and scleroderma-like lesions. Other symptoms include headache, a vague feeling of fullness in the head, dizziness, vertigo, vision disturbances, dyspnea, and aquagenic pruritus.
Rheumatoid arthritis
This disorder may cause skin mottling. Early nonspecific signs and symptoms progress to joint pain and stiffness with subcutaneous nodules, usually on the elbows.
Systemic lupus erythematosus
This connective tissue disorder can cause livedo reticularis, most commonly on the outer arms. Other signs and symptoms include a butterfly rash, nondeforming joint pain and stiffness, photosensitivity, Raynaud’s phenomenon, patchy alopecia, seizures, fever, anorexia, weight loss, lymphadenopathy, and emotional lability.
Other causes
Immobility
Prolonged immobility may cause bluish mottling, most noticeably in dependent extremities.
Thermal exposure
Prolonged thermal exposure, as from a heating pad or hot water bottle, may cause erythema Ab Igne—a localized, reticulated, brown-to-red mottling.
Skin, scaly:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Bowen’s disease
This common form of intraepidermal carcinoma causes painless, erythematous plaques that are raised and indurated with a thick, hyperkeratotic scale and, possibly, ulcerated centers.
Dermatitis
Exfoliative dermatitis begins with rapidly developing generalized erythema. Desquamation with fine scales or thick sheets of all or most of the skin surface may cause life-threatening hypothermia. Other possible complications include cardiac output failure and septicemia. Systemic signs and symptoms include low-grade fever, chills, malaise, lymphadenopathy, and gynecomastia.
With nummular dermatitis, round, pustular lesions commonly ooze purulent exudate, itch severely, and rapidly become encrusted and scaly. Lesions appear on the extensor surfaces of the limbs, posterior trunk, and buttocks.
Seborrheic dermatitis begins with erythematous, scaly papules that progress to larger, dry or moist, greasy scales with yellowish crusts. This disorder primarily involves the center of the face, the chest and scalp and, possibly, the genitalia, axillae, and perianal regions. Pruritus occurs with scaling.
Dermatophytosis
Tinea capitis produces lesions with reddened, slightly elevated borders and a central area of dense scaling; these lesions may become inflamed and pus-filled (kerions). Patchy alopecia and itching may also occur. Tinea pedis causes scaling and blisters between the toes. The squamous type produces diffuse, fine, branlike scales. Adherent and silvery white, they’re most prominent in skin creases and may affect the entire dorsum of the foot. Tinea corporis produces crusty lesions. As they enlarge, their centers heal, causing the classic ringworm shape.
Discoid lupus erythematosus
This cutaneous form of lupus may occur without systemic signs and symptoms. Separate or coalescing lesions (macules, papules, or plaques), ranging from pink to purple, are covered with a yellow or brown crust. Enlarged hair follicles are filled with scales, and telangiectasia may be present. After this inflammatory stage, the lesions heal and hypopigmentation or hyperpigmentation and noncontractile scarring and atrophy may occur. Discoid lupus commonly involves the face or sun-exposed areas of the neck, ears, scalp, lips, and oral mucosa. Alopecia may also occur.
Lichen planus
With this disorder, small, flat, violet lesions with a fine scale and gray lines on the surface usually affect the lumbar region, genitalia, wrists, ankles, and anterior lower legs.
Lymphoma
Hodgkin’s disease and non-Hodgkin’s lymphoma commonly cause scaly rashes. Hodgkin’s disease may cause pruritic scaling dermatitis that begins in the legs and spreads to the entire body. Remissions and recurrences are common. Small nodules and diffuse pigmentation are related signs. This disease typically produces painless enlargement of the peripheral lymph nodes. Other signs and symptoms include fever, fatigue, weight loss, malaise, and hepatosplenomegaly.
Non-Hodgkin’s lymphoma initially produces erythematous patches with some scaling that later become interspersed with nodules. Pruritus and discomfort are common; later, tumors and ulcers form. Progression produces nontender lymphadenopathy.
Parapsoriasis (chronic)
This disorder produces small or moderate-sized maculopapular, erythematous eruption, with a thin, adherent scale on the trunk, hands, and feet. Removal of the scale reveals a shiny brown surface.
Pityriasis
Pityriasis rosea, an acute, benign, and self-limiting disorder, produces widespread scales. It begins with an erythematous, raised, oval herald patch anywhere on the body. A few days or weeks later, yellow-tan or erythematous patches with scaly edges erupt on the trunk and limbs and sometimes on the face, hands, and feet. Pruritus also occurs.
Pityriasis rubra pilaris, an uncommon disorder, initially produces seborrheic scaling on the scalp, progressing to the face and ears. Later, scaly red patches develop on the palms and soles, becoming diffuse, thick, fissured, hyperkeratotic, and painful. Lesions also appear on the hands, fingers, wrists, and forearms and then on wide areas of the trunk, neck, and limbs.
Psoriasis
Silvery white, micaceous scales cover erythematous plaques that have sharply defined borders. Psoriasis usually appears on the scalp, chest, elbows, knees, back, buttocks, and genitalia. Associated signs and symptoms include nail pitting, pruritus, arthritis, and sometimes pain from dry, cracked, encrusted lesions.
Syphilis (secondary)
Papulosquamous, slightly scaly eruptions characterize this disorder. A ring-shaped pattern of copper-red papules usually forms on the face, arms, palms, soles, chest, back, and abdomen. Annular papules may occur. Systemic findings include lymphadenopathy, malaise, weight loss, anorexia, nausea, vomiting, headache, sore throat, and low-grade fever.
Systemic lupus erythematosus
This disorder produces a bright-red maculopapular eruption, sometimes with scaling. Patches are sharply defined and involve the nose and malar regions of the face in a butterfly pattern—a primary sign. Similar characteristic rashes appear on other body surfaces; scaling occurs along the lower lip or anterior hair line. Other primary signs and symptoms include photosensitivity and joint pain and stiffness. Vasculitis (leading to infarctive lesions, necrotic leg ulcers, or digital gangrene), Raynaud’s phenomenon, patchy alopecia, and mucous membrane ulcers also can occur.
Tinea versicolor
This benign fungal skin infection typically produces macular hypopigmented, fawn-colored, or brown patches of varying sizes and shapes. All are slightly scaly. Lesions commonly affect the upper trunk, arms, and lower abdomen, sometimes the neck and, rarely, the face.
Other causes
Drugs
Many drugs—including penicillins, sulfonamides, barbiturates, quinidine, diazepam, phenytoin, and isoniazid—can produce scaling patches.
Arthritis/Dermatitis:
Differential Overview
(Field Guide to Bedside Diagnosis)
❑Lyme disease
❑Erythema nodosum
❑Rheumatoid arthritis
❑Systemic lupus erythematosus
❑Psoriatic arthritis
❑Disseminated gonococcemia
❑Sarcoidosis
❑Scleroderma
❑Dermatomyositis
❑Reiter syndrome
❑Rheumatic fever
❑Behçet syndrome
❑Still disease
❑Hypersensitivity vasculitis
Clinical Findings
Lyme disease Erythema migrans, a rapidly expanding annular rash with a clearing center, is the key early finding. The site of the ixodid tick bite at the center of the lesion is usually intensely indurated, vesicular, or necrotic. The arthritis is an asymmetric oligoarthritis that usually occurs after the rash has resolved.
Erythema nodosum A prodromal syndrome of fever, chills, malaise, and polyarthralgia is followed by the development of lesions that are discrete, tender, slightly raised subcutaneous nodules on the shins or ankles. They represent a hypersensitivity reaction to group A streptococcal infection, tuberculosis, sarcoidosis, inflammatory bowel disease, or drugs such as oral contraceptives and sulfonamides.
Rheumatoid arthritis Symmetric polyarticular arthritis with synovial proliferation, especially of the wrist, and morning stiffness lasting more than 1 hour characterize the early joint involvement. Rheumatoid nodules appear over extensor surfaces. Vasculitic lesions are frequently found on the digits, appearing as small red or purpuric macules that progress to painful nodules or ulcers.
Systemic lupus erythematosus A classic butterfly rash occurs in 40% and is exacerbated by sun exposure. A diffuse maculopapular rash in areas exposed to the sun heralds disease flares. Discoid lesions and scaling plaques that range in color from red to violaceous, with central atrophy and telangiectasias, occur in 20%. Vasculitis, in the form of painful ulcers on the extremities, palpable purpura, or lupus profundus (firm nodules in the subcutaneous fat on the forehead, cheeks, buttocks, and upper arms) are found. The arthritis is typically one of symmetric fusiform swelling of the proximal interphalangeal and metacarpophalangeal joints, diffuse puffiness of the hands, and tenosynovitis.
Psoriatic arthritis Psoriatic plaques, erythematous with a silvery scale, are critical to diagnosis, but may be hidden in the scalp, umbilicus, or gluteal folds. Nail changes such as pitting or yellow discoloration of the nail plate are other clues. The arthritis typically involves the proximal interphalangeal and distal interphalangeal joints, creating sausage digits. The arthritis may become erosive, leading to telescoping of the hands. One-fourth of patients have axial skeletal arthritis.
Disseminated gonococcemia Acral lesions are typically hemorrhagic pustules, but petechiae, hemorrhagic papules, or hemorrhagic bullae can occur. Fever, rigor, tenosynovitis, and polyarthritis are other findings.
Sarcoidosis Transient maculopapular eruptions of the trunk, face, and extremities are often accompanied by uveitis, adenopathy, and parotid enlargement. Translucent reddish-brown to purple indolent plaques may develop on the face (lupus pernio), buttocks, or extremities. Joint symptoms consist of migratory transient arthralgias.
Scleroderma Early findings are primarily Raynaud phenomenon and puffy fingers. Later findings include sclerodactyly (smooth, shiny, tapered fingers with taut, bound-down skin); contractures with “claw hand” deformity; expressionless face (with thin lips, a beak-like nose, and sunken cheeks); microstomia; mat telangiectasias on the nail folds, face, lips, oral mucosa, or trunk; and calcinosis with leathery crepitation over the joints.
Dermatomyositis The classic skin manifestation is a lilac-colored heliotrope rash on the eyelids and in a butterfly distribution. Gottron papules are violaceous, scaly, flat lesions on the extensor aspect of the interphalangeal joints, elbows, knees, and medial malleoli; these occur as a late manifestation. Proximal muscle aching/weakness, not arthritis, is prominent. The patient is unable to reach overhead or arise from a chair. Neck flexors are more involved than extensors.
Reiter syndrome Arthritis, urethritis, conjunctivitis, and mucocutaneous ulcers are found. The arthritis is asymmetric, usually involving the lower extremity joints. Solitary sausage digits may be seen. Tendinitis and fasciitis are common. The mucocutaneous lesions are eroded red vesicles or papules of the corona and glans, which when confluent are called circinate balanitis. Pustules may change into thick hyperkeratotic plaques on the palms and soles, keratoderma blennorrhagicum.
Rheumatic fever There is an acute migratory polyarthritis with fever. Subcutaneous nodules appear over the bony prominences of the elbows, knuckles, ankles, scapulae, and occiput. They are associated with carditis. Erythema marginatum, appearing as evanescent pink lesions with serpiginous borders, is also associated with carditis.
Behçet syndrome The classic triad is arthritis, iritis, and oral and genital ulcerations. Recurrent aphthous ulcers are a sine qua non. They begin as macular erythema that develops into superficial gray ulcers. Scrotal or labial ulcerations are also found. Hypopyon uveitis, a hallmark, is a rare finding. The arthritis is primarily of the knees and ankles.
Still disease Skin lesions are red, flat, and less than 1 cm in diameter. Lesions are evanescent, occurring with fever spikes. A migratory polyarthralgia occurs.
Hypersensitivity vasculitis After an upper respiratory infection, young adults may develop palpable purpura over the extensor surfaces and buttocks. Arthritis, edema, and colicky abdominal pain, followed by bloody stools, suggests the diagnosis.
Dermatitis:
Causes
(Handbook of Diseases)
The cause of atopic dermatitis is unknown, but there is a genetic predisposition exacerbated by such factors as food allergies, infections, irritating chemicals, temperature and humidity, and emotions. Approximately 10% of childhood cases are caused by allergy to certain foods, particularly eggs, peanuts, milk, and wheat.
Atopic dermatitis tends to flare up in response to extremes in temperature and humidity. Other causes of flare-ups are sweating and psychological stress.
An important secondary cause of atopic dermatitis is irritation, which seems to change the epidermal structure, allowing immunoglobulin (Ig) E activity to increase. Consequently, chronic skin irritation usually continues even after exposure to the allergen has ended or after the irritation has been systemically controlled.
Staphylococcal scalded skin syndrome:
Causes
(Handbook of Diseases)
The causative organism in SSSS is Group 2 Staphylococcus aureus, primarily phage type 71. Predisposing factors may include impaired immunity and renal insufficiency — present to some extent in the normal neonate because of immature development of these systems.
Skin, clammy:
Medical causes
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Anxiety
An acute anxiety attack commonly produces cold, clammy skin on the forehead, palms, and soles. Other features include pallor, dry mouth, tachycardia or bradycardia, palpitations, and hypertension or hypotension. The patient may also develop tremors, breathlessness, headache, muscle tension, nausea, vomiting, abdominal distention, diarrhea, increased urination, and sharp chest pain.
Arrhythmias
Cardiac arrhythmias may produce generalized cool, clammy skin along with mental status changes, dizziness, and hypotension.
Cardiogenic shock
Generalized cool, moist, pale skin accompanies confusion, restlessness, hypotension, tachycardia, tachypnea, narrowing pulse pressure, cyanosis, and oliguria.
Heat exhaustion
In the acute stage of heat exhaustion, generalized cold, clammy skin accompanies an ashen appearance, headache, confusion, syncope, giddiness and, possibly, a subnormal temperature, with mild heat exhaustion. The patient may exhibit a rapid and thready pulse, nausea, vomiting, tachypnea, oliguria, thirst, muscle cramps, hypotension, blurred vision, and loss of consciousness.
Hypoglycemia (acute)
Generalized cool, clammy skin or diaphoresis may accompany irritability, tremors, palpitations, hunger, headache, tachycardia, and anxiety. Central nervous system disturbances include blurred vision, diplopia, confusion, motor weakness, hemiplegia, and coma. These signs and symptoms typically resolve after the patient is given glucose.
Hypovolemic shock
With this common form of shock, generalized pale, cold, clammy skin accompanies subnormal body temperature, hypotension with narrowing pulse pressure, tachycardia, tachypnea, and a rapid, thready pulse. Other findings are flat neck veins, increased capillary refill time, decreased urine output, confusion, and a decreased level of consciousness.
Septic shock
The cold shock stage causes generalized cold, clammy skin. Associated findings include a rapid and thready pulse, severe hypotension, persistent oliguria or anuria, and respiratory failure.
Skin, mottled:
Medical causes
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Acrocyanosis
. With acrocyanosis, a rare disorder, anxiety or exposure to cold can cause vasospasm in small cutaneous arterioles. This results in persistent symmetrical blue and red mottling of the affected hands, feet, and nose.Arterial occlusion (acute)
Initial signs include temperature and color changes. Pallor may change to blotchy cyanosis and livedo reticularis. Color and temperature demarcation develop at the level of the obstruction. Other effects include a sudden onset of pain in the extremity and possibly paresthesia, paresis, and a sensation of cold in the affected area. Examination reveals diminished or absent pulses, cool extremities, increased capillary refill time, pallor, and diminished reflexes.
Arteriosclerosis obliterans
Atherosclerotic buildup narrows intra-arterial lumina, resulting in reduced blood flow through the affected artery. Obstructed blood flow to the extremities (most commonly the lower) produces such peripheral signs and symptoms as leg pallor, cyanosis, blotchy erythema, and livedo reticularis. Related findings include intermittent claudication (most common symptom), diminished or absent pedal pulses, and leg coolness. Other symptoms include coldness and paresthesia.
Buerger’s disease
A form of vasculitis, Buerger’s disease produces unilateral or asymmetrical color changes and mottling, particularly livedo networking in the lower extremities. It also typically causes intermittent claudication and erythema along extremity blood vessels. During exposure to cold, the feet are cold, cyanotic, and numb; later, they’re hot, red, and tingling. Other findings include impaired peripheral pulses and peripheral neuropathy. Buerger’s disease is typically exacerbated by smoking.
Cryoglobulinemia
A necrotizing disorder, cryoglobulinemia causes patchy livedo reticularis, petechiae, and ecchymoses. Other findings include fever, chills, urticaria, melena, skin ulcers, epistaxis, Raynaud’s phenomenon, eye hemorrhage, hematuria, and gangrene.
Hypovolemic shock
Vasoconstriction from shock commonly produces skin mottling, initially in the knees and elbows. As shock worsens, mottling becomes generalized. Early signs include a sudden onset of pallor, cool skin, restlessness, thirst, tachypnea, and slight tachycardia. As shock progresses, associated findings include cool, clammy skin as well as a rapid, thready pulse accompanied by hypotension, narrowed pulse pressure, decreased urine output, subnormal temperature, confusion, and a decreased level of consciousness.
Livedo reticularis (idiopathic or primary)
Symmetrical, diffuse mottling can involve the hands, feet, arms, legs, buttocks, and trunk. Initially, networking is intermittent and most pronounced on exposure to cold or stress; eventually, mottling persists even with warming.
Periarteritis nodosa
Skin findings include asymmetrical, patchy livedo reticularis, palpable nodules along the path of medium-sized arteries, erythema, purpura, muscle wasting, ulcers, gangrene, peripheral neuropathy, fever, weight loss, and malaise.
Polycythemia vera
A hematologic disorder, polycythemia vera produces livedo reticularis, hemangiomas, purpura, rubor, ulcerative nodules, and scleroderma-like lesions. Other symptoms include headache, a vague feeling of fullness in the head, dizziness, vertigo, vision disturbances, dyspnea, aquagenic pruritus, and night sweats.
Rheumatoid arthritis (RA)
RA may cause skin mottling. Early nonspecific signs and symptoms progress to joint pain and stiffness with subcutaneous nodules, usually on the elbows.
Systemic lupus erythematosus (SLE)
A connective tissue disorder, SLE can cause livedo reticularis, most commonly on the outer arms. Other signs and symptoms include a butterfly rash, nondeforming joint pain and stiffness, photosensitivity, Raynaud’s phenomenon, patchy alopecia, seizures, fever, anorexia, weight loss, lymphadenopathy, and emotional lability.
Other causes
Immobility
Prolonged immobility may cause bluish mottling, most noticeably in dependent extremities.
Thermal exposure
Prolonged thermal exposure, such as from a heating pad or hot water bottle, may cause erythema ab igne —a localized, reticulated, brown-to-red mottling.
Skin, bronze:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Adrenal hyperplasia
With adrenal hyperplasia, the skin assumes a dark bronze tone within a few months. Other findings include visual field deficits and headache (from an expanding pituitary lesion), and signs of masculinization in females such as clitoral enlargement, and male distribution of hair, fat, and muscle mass.
Biliary cirrhosis
Biliary cirrhosis causes bronze skin from melanosis of exposed areas of jaundiced skin: eyelids, palms, neck, and chest or back. The patient may also experience generalized pruritus, weakness, fatigue, jaundice, dark urine, pale stools with steatorrhea, decreased appetite with weight loss, and hepatomegaly.
Hemochromatosis
An early sign of hemochromatosis is progressive, generalized bronzing accentuated by metallic gray-bronze skin on sun-exposed areas, genitalia, and scars. Mucous membranes are affected less often. Early associated effects include weakness, lethargy, weight loss, abdominal pain, loss of libido, polydipsia, and polyuria.
CULTURAL CUE:Hereditary hemochromatosis is the most common genetic disorder in whites, affecting 1 in 200 to 300 people of Northern European descent.
Malnutrition
As weight loss, which occurs from malnutrition, depletes body nutrients, bronzing develops along with apathy, lethargy, anorexia, weakness, and slow pulse and respiratory rates. Patients may develop paresthesia in the extremities; dull, sparse, dry hair; brittle nails; dark, swollen cheeks; dry, flaky skin; red, swollen lips; muscle wasting; and gonadal atrophy in males.
Primary adrenal insufficiency
Bronze skin is a classic sign of primary adrenal insufficiency. Other findings include axillary and pubic hair loss, vitiligo, progressive fatigue, weakness, anorexia, nausea and vomiting, weight loss, orthostatic hypotension, weak and irregular pulse, abdominal pain, irritability, diarrhea or constipation, amenorrhea, and syncope.
Renal failure (chronic)
With chronic renal failure, the skin becomes pallid, yellowish bronze, dry, and scaly. Other findings include ammonia breath odor, oliguria, fatigue, decreased mental acuity, seizures, muscle cramps, peripheral neuropathy, bleeding tendencies, pruritus and, occasionally, uremic frost and hypertension.
Other causes
Drugs
Prolonged therapy with high doses of a phenothiazine may cause gradual bronzing of the skin.
Skin, clammy:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Anxiety
An acute anxiety attack commonly produces cold, clammy skin on the forehead, palms, and soles. Other features include pallor, dry mouth, tachycardia or bradycardia, palpitations, and hypertension or hypotension. The patient may also develop tremors, breathlessness, headache, muscle tension, nausea, vomiting, abdominal distention, diarrhea, increased urination, and sharp chest pain.
Cardiac arrhythmias
Cardiac arrhythmias may produce generalized cool, clammy skin along with mental status changes, dizziness, and hypotension. The pulse rate may be rapid, slow, or irregular. The patient may report palpitations, chest pain, diaphoresis, light-headedness, and weakness.
Cardiogenic shock
With cardiogenic shock, generalized cool, moist, pale skin accompanies confusion, restlessness, hypotension, tachycardia, tachypnea, narrowing pulse pressure, cyanosis, and oliguria. Associated signs and symptoms include anginal pain, dyspnea, jugular vein distention, ventricular gallop, and a weak, rapid pulse.
Heat exhaustion
In the acute stage of heat exhaustion, generalized cold, clammy skin accompanies an ashen appearance, headache, confusion, syncope, giddiness and, possibly, a subnormal temperature, with mild heat exhaustion. The patient may exhibit a rapid and thready pulse, nausea, vomiting, tachypnea, oliguria, thirst, muscle cramps, and hypotension.
Hypoglycemia (acute)
With acute hypoglycemia, generalized cool, clammy skin or diaphoresis may accompany irritability, tremors, palpitations, hunger, headache, tachycardia, and anxiety. Central nervous system disturbances include blurred vision, diplopia, confusion, motor weakness, hemiplegia, and coma. These signs and symptoms typically resolve after the patient is given glucose.
Hypovolemic shock
With hypovolemic shock, generalized pale, cold, clammy skin accompanies subnormal body temperature, hypotension with narrowing pulse pressure, tachycardia, tachypnea, and rapid, thready pulse. Other findings are flat neck veins, increased capillary refill time, decreased urine output, confusion, and decreased level of consciousness.
Septic shock
The cold shock stage of septic shock causes generalized cold, clammy skin. Associated findings include rapid and thready pulse, severe hypotension, persistent oliguria or anuria, and respiratory failure.
Skin, mottled:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Arterial occlusion (acute)
Initial signs of acute arterial occlusion include temperature and color changes. Pallor may change to blotchy cyanosis and livedo reticularis. Color and temperature demarcation develop at the level of obstruction. Other effects include sudden onset of pain in the extremity and possibly paresthesia, paresis, and a sensation of cold in the affected area. Examination reveals diminished or absent pulses, cool extremities, increased capillary refill time, pallor, and diminished reflexes.
Arteriosclerosis obliterans
Atherosclerotic buildup narrows intra-arterial lumina, resulting in reduced blood flow through the affected artery. Obstructed blood flow to the extremities (most commonly the lower) produces such peripheral signs and symptoms as leg pallor, cyanosis, blotchy erythema, and livedo reticularis. Related findings include intermittent claudication (most common symptom), diminished or absent pedal pulses, and leg coolness. Other symptoms include coldness and paresthesia.
Buerger’s disease
Buerger’s disease is a form of vasculitis that produces unilateral or asymmetrical color changes and mottling, particularly livedo networking in the lower extremities. It also typically causes intermittent claudication and erythema along extremity blood vessels. During exposure to cold, the feet are cold, cyanotic, and numb; later they’re hot, red, and tingling. Other findings include impaired peripheral pulses and peripheral neuropathy. Buerger’s disease is typically exacerbated by smoking.
Hypovolemic shock
Vasoconstriction from hypovolemic shock commonly produces skin mottling, initially in the knees and elbows. As shock worsens, mottling becomes generalized. Early signs include sudden onset of pallor, cool skin, restlessness, thirst, tachypnea, and slight tachycardia. As shock progresses, associated findings include cool, clammy skin; rapid, thready pulse; hypotension; narrowed pulse pressure; decreased urine output; subnormal temperature; confusion; and decreased level of consciousness.
Livedo reticularis (idiopathic or primary)
With livedo reticularis, symmetrical, diffuse mottling can involve the hands, feet, arms, legs, buttocks, and trunk. Initially, networking is intermittent and most pronounced on exposure to cold or stress; eventually, mottling persists even with warming.
Polycythemia vera
Polycythemia vera, a hematologic disorder, produces livedo reticularis, hemangiomas, purpura, rubor, ulcerative nodules, and scleroderma-like lesions. Other symptoms include headache, a vague feeling of fullness in the head, dizziness, vertigo, vision disturbances, dyspnea, and aquagenic pruritus.
Rheumatoid arthritis
Rheumatoid arthritis may cause skin mottling. Early nonspecific signs and symptoms progress to joint pain and stiffness with subcutaneous nodules, usually on the elbows. The patient may report morning stiffness.
Systemic lupus erythematosus
Systemic lupus erythematosus (SLE) is a connective tissue disorder that can cause livedo reticularis, most commonly on the outer arms. Other signs and symptoms include a butterfly rash, nondeforming joint pain and stiffness, photosensitivity, Raynaud’s phenomenon, patchy alopecia, seizures, fever, anorexia, weight loss, lymphadenopathy, and emotional lability.
Other causes
Immobility
Prolonged immobility may cause bluish mottling, most noticeably in dependent extremities.
Thermal exposure
Prolonged thermal exposure, such as from a heating pad or hot water bottle, may cause erythema Ab Igne — a localized, reticulated, brown-to-red mottling.
Skin, scaly:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Bowen’s disease
Bowen’s disease, a common form of intraepidermal carcinoma, causes painless, erythematous plaques that are raised and indurated with a thick, hyperkeratotic scale and, possibly, ulcerated centers. The head and neck are the most commonly affected sites.
Dermatitis
Exfoliative dermatitis begins with rapidly developing generalized erythema. Desquamation with fine scales or thick sheets of all or most of the skin surface may cause life-threatening hypothermia. Other possible complications include cardiac output failure and septicemia. Systemic signs and symptoms include low-grade fever, chills, malaise, lymphadenopathy, and gynecomastia.
With nummular dermatitis, round, pustular lesions commonly ooze purulent exudate, itch severely, and rapidly become encrusted and scaly. Lesions appear on the extensor surfaces of the limbs, posterior trunk, and buttocks.
Seborrheic dermatitis begins with erythematous, scaly papules that progress to larger, dry or moist, greasy scales with yellowish crusts. This disorder primarily involves the center of the face, the chest and scalp and, possibly, the genitalia, axillae, and perianal regions. Pruritus occurs with scaling.
Dermatophytosis
Tinea capitis produces lesions with reddened, slightly elevated borders and a central area of dense scaling; these lesions may become inflamed and pus-filled (kerions). Patchy alopecia and itching may also occur. Tinea pedis causes scaling and blisters between the toes. The squamous type produces diffuse, fine, branlike scales. Adherent and silvery white, they’re most prominent in skin creases and may affect the entire dorsum of the foot. Tinea corporis produces crusty lesions. As they enlarge, their centers heal, causing the classic ringworm shape.
Discoid lupus erythematosus
Discoid lupus erythematosus is a cutaneous form of lupus that may occur without systemic signs and symptoms. Separate or coalescing lesions (macules, papules, or plaques), ranging from pink to purple, are covered with a yellow or brown crust. Enlarged hair follicles are filled with scales, and telangiectasia may be present. After this inflammatory stage, the lesions heal and hypopigmentation or hyperpigmentation and noncontractile scarring and atrophy may occur. Discoid lupus commonly involves the face or sun-exposed areas of the neck, ears, scalp, lips, and oral mucosa. Alopecia may also occur.
Lymphoma
Hodgkin’s disease and non-Hodgkin’s lymphoma commonly cause scaly rashes. Hodgkin’s disease may cause pruritic scaling dermatitis that begins in the legs and spreads to the entire body. Remissions and recurrences are common. Small nodules and diffuse pigmentation are related signs. This disease typically produces painless enlargement of the peripheral lymph nodes. Other signs and symptoms include fever, fatigue, weight loss, malaise, and hepatosplenomegaly.
Non-Hodgkin’s lymphoma initially produces erythematous patches with some scaling that later become interspersed with nodules. Pruritus and discomfort are common; later, tumors and ulcers form. Progression produces nontender lymphadenopathy.
Pityriasis rosea
Pityriasis rosea, an acute, benign, and self-limiting disorder, produces widespread scales. It begins with an erythematous, raised, oval herald patch anywhere on the body. A few days or weeks later, yellow-tan or erythematous patches with scaly edges erupt on the trunk and limbs and sometimes on the face, hands, and feet. Pruritus also occurs.
Psoriasis
Silvery white, micaceous scales cover erythematous plaques that have sharply defined borders. Psoriasis usually appears on the scalp, chest, elbows, knees, back, buttocks, and genitalia. Associated signs and symptoms include nail pitting, pruritus, arthritis, and sometimes pain from dry, cracked, encrusted lesions.
Syphilis (secondary)
Papulosquamous, slightly scaly eruptions characterize secondary syphilis. A ring-shaped pattern of copper-red papules usually forms on the face, arms, palms, soles, chest, back, and abdomen. Annular papules may occur. Systemic findings include lymphadenopathy, malaise, weight loss, anorexia, nausea, vomiting, headache, sore throat, and low-grade fever.
Systemic lupus erythematosus
Systemic lupus erythematosus (SLE) produces a bright-red maculopapular eruption, sometimes with scaling. Patches are sharply defined and involve the nose and malar regions of the face in a butterfly pattern — a primary sign. Similar characteristic rashes appear on other body surfaces; scaling occurs along the lower lip or anterior hair line. Other primary signs and symptoms include photosensitivity and joint pain and stiffness. Vasculitis (leading to infarctive lesions, necrotic leg ulcers, or digital gangrene), Raynaud’s phenomenon, patchy alopecia, and mucous membrane ulcers also can occur.
Tinea versicolor
Tinea versicolor, a benign fungal skin infection, typically produces macular hypopigmented, fawn-colored, or brown patches of varying sizes and shapes. All are slightly scaly. Lesions commonly affect the upper trunk, arms, and lower abdomen, sometimes the neck and, rarely, the face.
Other causes
Drugs
Many drugs — including penicillins, sulfonamides, barbiturates, quinidine, diazepam, phenytoin, and isoniazid — can produce scaling patches.
Skin Lesions and Rashes:
Principal Causes of Skin Lesions and Rashes
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
- Blistering(vesiculobullous) lesions
- Miliaria
- Allergic contact dermatitis
- Chemical and thermal burns
- Friction blisters
- Frostbite
- Bullous impetigo
- Papular urticaria (insect bites)
- Hand-foot-mouth disease
- Varicella-zoster virus infections
- Herpes simplex virus infections
- Erythema multiforme
- Staphylococcal scalded skin syndrome
- Epidermolysis bullosa
- Chronic bullous dermatitis of childhood(linear immunoglobulin A dermatosis)
- Dermatitis herpetiformis
- Bullous pemphigoid
- Incontinentia pigmenti
- Pustular lesions
- Erythematoxicum
- Transient neonatal pustular melanosis
- Acne
- Folliculitis
- Eosinophilic pustular folliculitis
- Infantile acropustulosis
- Miliaria
- Candidiasis
- Herpes simplex virus infections
- Local bacterial infections (Staphylococcusaureus)
- Scabies
- Skin-colored papules and nodules
- Smoothsurface
- Milia
- Molluscum contagiosum
- Acne
- Epidermal cyst
- Granuloma annulare
- Lipoma
- Juvenile xanthogranuloma
- Xanthoma
- Neurofibroma
- Rough surface
- Epidermal nevi
- Warts
- Corns and calluses
- Keratosis pilaris
- Smoothsurface
- White lesions
- Flat lesions
- Postinflammatory hypopigmentation
- Pityriasis alba
- Tinea versicolor
- Vitiligo
- Piebaldism
- Ash-leaf macules
- Hypomelanosis of Ito
- Chediak-Higashi syndrome
- Waardenburg syndrome
- Raised lesions
- Milia
- Acne
- Keratosis pilaris
- Molluscum contagiosum
- Flat lesions
- Brown, blue-black, or black lesions
- Flat lesions
- Freckles(ephelides)
- Mongolian spots (dermal melanosis)
- Café au lait spots
- Lentigines
- Nevi of Ota and of Ito
- Congenital nevocellular nevi
- Acquired nevocellular nevi
- Nevus spilus (speckled lentiginousnevus)
- Spitz nevi (spindle epithelioid nevi)
- Epidermal nevi
- Raised lesions
- Postinflammatoryhyperpigmentation
- Mastocytoma and urticaria pigmentosa
- Pyogenic granuloma
- Dysplastic melanocytic nevi
- Melanoma
- Flat lesions
- Yellow lesions
- Jaundice
- Carotenemia
- Sebaceous gland hyperplasia
- Nevus sebaceous of Jadassohn
- Inflammatory papules and nodules
- Insectbites
- Acne
- Roseola (exanthem subitum)
- Enteroviruses (coxsackie A and B viruses,echoviruses)
- Epstein-Barr virus
- Parvovirus B19 (fifth disease)
- Postnatal rubella
- Measles (rubeola)
- Scarlet fever
- Cellulitis
- Furuncle
- Candidiasis
- Kawasaki disease
- Mycoplasma infections
- Erythema marginatum
- Panniculitis
- Erythema chronicum migrans
- Cutaneous larva migrans
- Urticaria (hives)
- Vascular reactions
- Blanching
- Mottling(cutis marmorata)
- Salmon patch
- Spider angioma
- Port-wine stains
- Hemangiomas
- Drug hypersensitivity reactions
- Erythema toxicum
- Urticaria
- Viral infections (exanthems)
- Scarlet fever
- Erythema multiforme
- Kawasaki disease
- Toxic shock syndrome
- Erythema chronicum migrans
- Syphilis
- Pyogenic granuloma
- Pityriasis rosea (early lesions)
- Guttate psoriasis (early lesions)
- Nonblanching (purpuric rashes)
- Meningococcemia
- Toxic shock syndrome
- Rocky Mountain spotted fever
- Other
- Blanching
- Papulosquamous disorders
- Diaperdermatitis (irritant dermatitis)
- Atopic dermatitis
- Nummular eczematous dermatitis
- Juvenile plantar dermatosis (foot eczema)
- Seborrheic dermatitis (infantile)
- Contact dermatitis
- Tinea corporis
- Tinea pedis
- Candidiasis
- Sunburn
- Pityriasis rosea
- Drug eruptions
- Scabies
- Polymorphous light eruption
- Psoriasis
- Parapsoriasis
- Lichen nitidis
- Lichen striatus
- Lichen planus
- Lupus erythematosus
- Dermatomyositis
- Langerhans cell histiocytosis
- Acrodermatitis enteropathica
- Human immunodeficiency virus infection
- Secondary syphilis
- Ichthyoses
- Ichthyosis vulgaris
- X-linked ichthyosis
- Classic lamellar ichthyosis and congenitalnonbullous ichthyosiform erythroderma
- Congenital bullous ichthyosiform erythroderma(epidermolytic hyperkeratosis)
Skin turgor, decreased:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Cholera.Cholera is characterized by abrupt watery diarrhea and vomiting, which leads to severe water and electrolyte loss. These imbalances cause the following symptoms: decreased skin turgor, thirst, weakness, muscle cramps, oliguria, tachycardia, and hypotension. Without treatment, death can occur within hours.
Dehydration.Decreased skin turgor commonly occurs with moderate to severe dehydration. Associated findings include dry oral mucosa, decreased perspiration, resting tachycardia, orthostatic hypotension, a dry and furrowed tongue, increased thirst, weight loss, oliguria, fever, and fatigue. As dehydration worsens, other findings include enophthalmos, lethargy, weakness, confusion, delirium or obtundation, anuria, and shock. Hypotension persists even when the patient lies down.
Skin, clammy:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Anxiety.An acute anxiety attack commonly produces cold, clammy skin on the forehead, palms, and soles. Other features include pallor, a dry mouth, tachycardia or bradycardia, palpitations, and hypertension or hypotension. The patient may also develop tremors, breathlessness, headache, muscle tension, nausea, vomiting, abdominal distention, diarrhea, increased urination, and sharp chest pain.
Arrhythmias.Cardiac arrhythmias may produce generalized cool, clammy skin along with mental status changes, dizziness, and hypotension.
Cardiogenic shock.Generalized cool, moist, pale skin accompanies confusion, restlessness, hypotension, tachycardia, tachypnea, narrowing pulse pressure, cyanosis, and oliguria.
Heat exhaustion.In the acute stage of heat exhaustion, generalized cold, clammy skin accompanies an ashen appearance, headache, confusion, syncope, giddiness and, possibly, a subnormal temperature, with mild heat exhaustion. The patient may exhibit a rapid and thready pulse, nausea, vomiting, tachypnea, oliguria, thirst, muscle cramps, and hypotension.
Hypoglycemia (acute).Generalized cool, clammy skin or diaphoresis may accompany irritability, tremors, palpitations, hunger, headache, tachycardia, and anxiety. Central nervous system disturbances include blurred vision, diplopia, confusion, motor weakness, hemiplegia, and coma. These signs and symptoms typically resolve after the patient is given glucose.
Hypovolemic shock.With hypovolemic shock, generalized pale, cold, clammy skin accompanies a subnormal body temperature, hypotension with narrowing pulse pressure, tachycardia, tachypnea, and a rapid, thready pulse. Other findings are flat neck veins, an increased capillary refill time, decreased urine output, confusion, and decreased level of consciousness.
Septic shock.The cold shock stage causes generalized cold, clammy skin. Associated findings include a rapid and thready pulse, severe hypotension, persistent oliguria or anuria, and respiratory failure.
Skin, mottled:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Acrocyanosis.With acrocyanosis, anxiety or exposure to cold can cause vasospasm in small cutaneous arterioles. This results in persistent symmetrical blue and red mottling of the affected hands, feet, and nose.
Arterial occlusion (acute).Initial signs of acute arterial occlusion include skin temperature and color changes. Pallor may change to blotchy cyanosis and livedo reticularis. Color and temperature demarcation develop at the level of obstruction. Other effects include sudden onset of pain in the extremity and, possibly, paresthesia, paresis, and a sensation of cold in the affected area. Examination reveals diminished or absent pulses, cool extremities, an increased capillary refill time, pallor, and diminished reflexes.
Arteriosclerosis obliterans.Atherosclerotic buildup narrows intra-arterial lumina, resulting in reduced blood flow through the affected artery. Obstructed blood flow to the extremities (most commonly the legs) produces such peripheral signs and symptoms as leg pallor, cyanosis, blotchy erythema, and livedo reticularis. Related findings include intermittent claudication (most common symptom), diminished or absent pedal pulses, and leg coolness. Other symptoms include coldness and paresthesia.
Buerger's disease.Buerger's disease produces unilateral or asymmetrical color changes and mottling, particularly livedo networking in the lower extremities. It also typically causes intermittent claudication and erythema along extremity blood vessels. During exposure to cold, the feet are cold, cyanotic, and numb; later they're hot, red, and tingling. Other findings include impaired peripheral pulses and peripheral neuropathy. Buerger's disease is typically exacerbated by smoking.
Cryoglobulinemia.Cryoglobulinemia causes patchy livedo reticularis, petechiae, and ecchymoses. Other findings include fever, chills, urticaria, melena, skin ulcers, epistaxis, Raynaud's phenomenon, eye hemorrhages, hematuria, and gangrene.
Hypovolemic shock.Vasoconstriction from hypovolemic shock commonly produces skin mottling, initially in the knees and elbows. As shock worsens, mottling becomes generalized. Early signs include a sudden onset of pallor, cool skin, restlessness, thirst, tachypnea, and slight tachycardia. As shock progresses, associated findings include cool, clammy skin; a rapid, thready pulse; hypotension; narrowed pulse pressure; decreased urine output; subnormal temperature; confusion; and decreased level of consciousness.
Livedo reticularis (idiopathic or primary).With livedo reticularis, symmetrical, diffuse mottling can involve the hands, feet, arms, legs, buttocks, and trunk. Initially, networking is intermittent and most pronounced on exposure to cold or stress; eventually, mottling persists even with warming.
Periarteritis nodosa.Skin findings in periarteritis nodosa include asymmetrical, patchy livedo reticularis, palpable nodules along the path of medium-sized arteries, erythema, purpura, muscle wasting, ulcers, gangrene, peripheral neuropathy, fever, weight loss, and malaise.
Polycythemia vera.Polycythemia vera produces livedo reticularis, hemangiomas, purpura, rubor, ulcerative nodules, and scleroderma-like lesions. Other symptoms include headache, a vague feeling of fullness in the head, dizziness, vertigo, vision disturbances, dyspnea, and aquagenic pruritus.
Systemic lupus erythematosus (SLE).SLE can cause livedo reticularis, most commonly on the outer arms. Other signs and symptoms include a butterfly rash, nondeforming joint pain and stiffness, photosensitivity, Raynaud's phenomenon, patchy alopecia, seizures, fever, anorexia, weight loss, lymphadenopathy, and emotional lability.
Other causes
Drugs.Vasoconstrictors administered at a high dose can cause mottling of the extremities.
Immobility.Prolonged immobility may cause bluish mottling, most noticeably in dependent extremities.
Thermal exposure.Prolonged thermal exposure, as from a heating pad or hot water bottle, may cause erythema ab igne—a localized, reticulated, brown-to-red mottling.
Skin, scaly:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Bowen's disease.Bowen's disease causes painless, erythematous plaques that are raised and indurated with a thick, hyperkeratotic scale and, possibly, ulcerated centers.
Dermatitis.Exfoliative dermatitis begins with rapidly developing generalized erythema. Desquamation with fine scales or thick sheets of all or most of the skin surface may cause life-threatening hypothermia. Other possible complications include cardiac output failure and septicemia. Systemic signs and symptoms include a low-grade fever, chills, malaise, lymphadenopathy, and gynecomastia.
With nummular dermatitis, round, pustular lesions commonly ooze purulent exudate, itch severely, and rapidly become encrusted and scaly. Lesions appear on the extensor surfaces of the limbs, posterior trunk, and buttocks.
Seborrheic dermatitis begins with erythematous, scaly papules that progress to larger, dry or moist, greasy scales with yellowish crusts. This disorder primarily involves the center of the face, the chest and scalp and, possibly, the genitalia, axillae, and perianal regions. Pruritus occurs with scaling.
Dermatophytosis.Tinea capitis produces lesions with reddened, slightly elevated borders and a central area of dense scaling; these lesions may become inflamed and pus-filled (kerions). Patchy alopecia and itching may also occur. Tinea pedis causes scaling and blisters between the toes. The squamous type produces diffuse, fine, branlike scales. Adherent and silvery white, they're most prominent in skin creases and may affect the entire dorsum of the foot. Tinea corporis produces crusty lesions. As they enlarge, their centers heal, causing the classic ringworm shape.
Lymphoma.Hodgkin's disease and non-Hodgkin's lymphoma commonly cause scaly rashes. Hodgkin's disease may cause pruritic scaling dermatitis that begins in the legs and spreads to the entire body. Remissions and recurrences are common. Small nodules and diffuse pigmentation are related signs. This disease typically produces painless enlargement of the peripheral lymph nodes. Other signs and symptoms include fever, fatigue, weight loss, malaise, and hepatosplenomegaly.
Non-Hodgkin's lymphoma initially produces erythematous patches with some scaling that later become interspersed with nodules. Pruritus and discomfort are common; later, tumors and ulcers form. Progression produces nontender lymphadenopathy.
Parapsoriasis (chronic).Parapsoriasisproduces small or moderate-sized maculopapular, erythematous eruptions, with a thin, adherent scale on the trunk, hands, and feet. Removal of the scale reveals a shiny brown surface.
Pityriasis.Pityriasis rosea, an acute, benign, and self-limiting disorder, produces widespread scales. It begins with an erythematous, raised, oval herald patch anywhere on the body. A few days or weeks later, yellow-tan or erythematous patches with scaly edges erupt on the trunk and limbs and sometimes on the face, hands, and feet. Pruritus also occurs.
Pityriasis rubra pilaris, an uncommon disorder, initially produces seborrheic scaling on the scalp, progressing to the face and ears. Later, scaly red patches develop on the palms and soles, becoming diffuse, thick, fissured, hyperkeratotic, and painful. Lesions also appear on the hands, fingers, wrists, and forearms and then on wide areas of the trunk, neck, and limbs.
Psoriasis.Silvery white, micaceous scales cover erythematous plaques that have sharply defined borders. Psoriasis usually appears on the scalp, chest, elbows, knees, back, buttocks, and genitalia. Associated signs and symptoms include nail pitting, pruritus, arthritis, and sometimes pain from dry, cracked, encrusted lesions.
Systemic lupus erythematosus (SLE).SLE produces a bright-red maculopapular eruption, sometimes with scaling. Patches are sharply defined and involve the nose and malar regions of the face in a butterfly pattern—a primary sign. Similar characteristic rashes appear on other body surfaces; scaling occurs along the lower lip or anterior hair line. Other primary signs and symptoms include photosensitivity and joint pain and stiffness. Vasculitis (leading to infarctive lesions, necrotic leg ulcers, or digital gangrene), Raynaud's phenomenon, patchy alopecia, and mucous membrane ulcers can also occur.
Tinea versicolor.Tinea versicolor typically produces macular hypopigmented, fawn-colored, or brown patches of varying sizes and shapes. All are slightly scaly. Lesions commonly affect the upper trunk, arms, and lower abdomen; sometimes the neck; and, rarely, the face.
Other causes
Drugs.Many drugs—including penicillins, sulfonamides, barbiturates, quinidine, diazepam, phenytoin, and isoniazid—can produce scaling patches.
Dermatitis as a symptom:
Conditions listing Dermatitis as a symptom may also be potential underlying causes of Dermatitis. Our database lists the following as having Dermatitis as a symptom of that condition:
- Abnormalities, Radiation-Induced
- Biotin deficiency
- Boron overuse
- Bullous Pemphigoid
- Candidiasis
- Chronic vitamin A toxicity
- Eosinophilic fasciitis
- Fistula
- Gold poisoning
- Mansonella ozzardi infection
- Pellagra
- Pellagra-like syndrome
- Phaeohyphomycosis
- Plant poisoning - poison ivy (Toxicodendron radicans)
- Polychondritis
- Postoperative Abdominal Wound Dehiscence
- Psoriasis
- PUPPPS
- Pyridoxine deficiency
- Rat-bite fever
- Scleroderma
- Seborrhoea
- Skin allergies
- Skin conditions
- Skin rash
- Spirurida Infections
- Sulfone syndrome
Medications or substances causing Dermatitis:
The following drugs, medications, substances or toxins are some of the possible
causes of Dermatitis as a symptom.
This list is incomplete and various other drugs or substances
may cause your symptoms.
Always advise your doctor of any medications or treatments you are using,
including prescription, over-the-counter, supplements, herbal or alternative treatments.
- Sulfur
- Clearasil Cream
- Egopsoryl TA
- Neo-Medrol Acne Lotion
- Glutaraldehyde
See full list of 68 medications causing Dermatitis
Medical news summaries relating to Dermatitis:
The following medical news items are relevant to causes of Dermatitis:
- 2.3.million adverse drug events reported to FDA over 33 years
- Acne medication may have contributed to suicide
- Dermatitis can cause hands to be dry, red, cracked and itchy
- Latex allergy
Related information on causes of Dermatitis:
As with all medical conditions, there may be many causal factors. Further relevant information on causes of Dermatitis may be found in:
» Next page: Risk Factors for Dermatitis
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- Risk Factors for Dermatitis
- Symptoms of Dermatitis
- Diagnostic Tests for Dermatitis
- Diagnosis of Dermatitis
- Signs of Dermatitis
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