From the Guidelines
Spongiotic dermatitis, also known as atopic dermatitis, is a condition that is strongly associated with a family history of atopy and loss of function mutations in the filaggrin (FLG) gene, with approximately 70% of patients having a positive family history of atopic diseases 1. The development of atopic dermatitis is influenced by various factors, including:
- A family history of atopy, with the odds of developing AD being 2- to 3-fold higher in children with one atopic parent, and increasing to 3- to 5-fold if both parents are atopic 1
- Loss of function mutations in the FLG gene, which confer a risk for earlier-onset AD, and for more severe, persistent disease 1
- Other potential risk factors, such as elevated birth weights, urban living, and higher levels of parental education, although the evidence for these factors is not as strong 1 The management of spongiotic dermatitis typically involves:
- Avoiding potential triggers, such as harsh soaps, fragrances, and known allergens
- Using moisturizers regularly, with ceramide-containing products being particularly effective
- Applying topical corticosteroids, such as triamcinolone 0.1% cream, for mild to moderate cases
- Considering oral antihistamines, such as cetirizine 10mg daily, for intense itching Breastfeeding for the first 6 months is recommended, as it has other benefits for the infant and mother, although it does not appear to alter the risk for AD 1.
From the Research
Definition and Characteristics of Spongiotic Dermatitis
- Spongiotic dermatitis is a type of skin condition characterized by epithelial intercellular edema, which may rarely form blisters 2
- It is pathologically defined by the presence of spongiotic tissue reaction pattern, which is the single most common and non-specific reaction pattern encountered in the routine analysis of inflammatory dermatoses 3
Types and Causes of Spongiotic Dermatitis
- Spongiotic dermatoses include a large list of disorders, such as contact dermatitis, eczema, pityriasis rosea, stasis dermatitis, and seborrheic dermatitis 3
- Generalized dermatitis, which is defined as histological spongiotic dermatitis affecting more than three anatomical areas of the skin surface, has many potential causes that mimic atopic dermatitis and contact dermatitis 4
- Contact dermatitis may be due to allergic contact dermatitis, irritant contact dermatitis, systemic contact dermatitis, contact urticaria, and protein contact dermatitis 5
Diagnosis and Treatment of Spongiotic Dermatitis
- The diagnosis of allergic contact dermatitis is based on a combination of clinical history, physical examination, and patch testing 5
- A diagnostic checklist can be useful in improving diagnostic efficiency and prompting consideration of diagnoses not otherwise considered in complex cases of recalcitrant dermatitis 4
- Treatment of spongiotic dermatitis may involve the use of topical corticosteroids, which are classified by strength and the risk of adverse effects 6