Autoeczematization

Abstract: "Conditioned hyperirritability" is a term used to describe the phenomenon wherein a dermatitis on one area of the body results in a heightened irritability of the whole skin, even in areas distant from the initial inflammation. This condition can include a pathologic spectrum ranging in intensity from pruritus to exfoliative dermatitis. Previously this disorder has been known to most dermatologists by other terms, including "autosensitization" and "autoeczematization." The exact etiology of conditioned hyperirritability, however, remains unknown. It does not appear to be an "id" eruption, as seen in dermatophyte infections, nor has it been found to be secondary to autoantibodies to skin. Conditioned hyperirritability has been associated most commonly with stasis ulcers of the lower extremities, and in some cases allergies to topical medicaments have been found. In this review is presented the clinical entity of conditioned hyperirritability, background research into this phenomenon, and possible etiologic mechanisms involved in conditioned hyperirritability.

Abstract: T helper 2 (Th2) and T helper 1 (Th1) mediated immune processes lie on a spectrum. Autoeczematization secondary to chronic stasis dermatitis may fall on the Th2 side of the spectrum due to skin stretch and chronic barrier dysfunction, supporting a primary Th2 response to self-antigen. In our patient, we posited that dupilumab would benefit autoeczematization secondary to chronic stasis dermatitis given its efficacy in atopic dermatitis, a Th2-mediated immune process. We report a case of clinical psoriasiform dermatitis, suggesting a shift toward a Th1-mediated immune process developing during dupilumab treatment for autoeczematization secondary to chronic stasis dermatitis.

Abstract: Autoeczematization, or id reaction, is a disseminated eczematous reaction that occurs due to a release of antigen(s) after exposure to a primary stimulus, with the eczema spreading to a site distant from the original one. This seemingly perplexing generalization most commonly is associated with stasis dermatitis or tinea pedis, though it may be caused by a wide variety of other disorders. We postulate that T cells are reactive to keratinocyte antigens that are produced during keratinocyte damage, which induce this autoeczematization. Studies with current technology are needed to facilitate further understanding of this phenomenon.

Abstract: Diaper dermatitis is the most common cutaneous diagnosis in infants. Most cases are associated with the yeast colonisation of Candida or diaper dermatitis candidiasis (DDC). It is an irritating and inflammatory acute dermatitis in the perineal and perianal areas resulting from the occlusion and irritation caused by diapers. Autoeczematization to a distant focus of dermatophyte infection very rarely presents as DDC. We present a 1-month-old boy with lesion on diaper area (gluteal area, perineum, groin and genitalia) and with clusters of pustules and vesicles on a large erythematous base over the dorsal area of both hands.