Impetiginized dyshidrotic eczema
Georgi Tchernev (Medical Institute of Ministry of Interior (MVR))
Matteo Zanardelli (Pharmacology, Toxicology and Innovative Treatments Department, Italy)
Cristiana Voicu (Polisano Clinic)
Ilko Bakardzhiev (Medical University of Varna)
T. Lotti (TU Delft - BT/Environmental Biotechnology, Sapienza University of Rome)
Jacopo Lotti (Sapienza University of Rome)
Katlein França (University of Miami Miller School of Medicine)
Atanas Batashki (Medical University of Plovdiv)
Uwe Wollina (Academic Teaching Hospital Dresden-Friedrichstadt)
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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 corticosteroids’ 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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