From the Guidelines
Infected dermatitis is characterized by a red, inflamed rash with signs of secondary infection, including yellow crusting, weeping, pustules, or purulence, and is often associated with increased pain, warmth, and poorly defined borders. The clinical characteristics of infected dermatitis rash can be identified by the presence of certain signs and symptoms, such as:
- Increased erythema and edema compared to non-infected dermatitis
- Yellow crusting, weeping, or pustules, which are indicative of secondary infection
- Impetiginization, characterized by honey-colored crusts, is a hallmark sign of Staphylococcus aureus infection, as noted in studies on dermatitis management 1
- Streptococcal infections may cause more diffuse erythema with a shiny appearance
- Patients may report increased pain rather than just itching, and the area may feel warm to touch
- In severe cases, cellulitis, lymphangitis, regional lymphadenopathy, or systemic symptoms like fever may be observed The diagnosis of infected dermatitis is primarily clinical, although wound cultures can identify specific pathogens and antibiotic sensitivities in resistant cases, as discussed in guidelines for the management of contact dermatitis 1 and atopic dermatitis 1. The most recent and highest quality study, published in 2023, emphasizes the importance of comprehensive history taking and physical exam in diagnosing atopic dermatitis and considering alternative or concomitant causes of dermatitis 1. Key characteristics of infected dermatitis include:
- Intensely erythematous skin with poorly defined borders
- Presence of crusting, weeping, or pustules
- Increased pain and warmth
- Potential for cellulitis, lymphangitis, or systemic symptoms in severe cases Proper treatment of infected dermatitis involves addressing both the underlying dermatitis and the infection, typically with a combination of topical steroids, anti-inflammatory agents, and antibiotics, as well as gentle skin care and moisturizing to restore the skin barrier and prevent recurrence.
From the Research
Clinical Characteristics of Infected Dermatitis Rash
The clinical characteristics of infected dermatitis rash can be identified through various studies, including:
- Infective dermatitis, which represents a severe form of recurrent eczematous skin change that presents in childhood 2
- Infectious eczematoid dermatitis (IED), characterized by an acute eczematous eruption triggered by purulent discharge from a primary infected site 3
- Contact dermatitis, a common inflammatory skin condition characterized by erythematous and pruritic skin lesions that occur after contact with a foreign substance 4
Key Features
Some key features of infected dermatitis rash include:
- Erythematous and pruritic skin lesions 4
- Peripherally spreading vesicles and pustules radiating from an infected site 3
- Crusty, scaly, and erythematous skin in older areas of involvement 3
- Xerosis, pruritus, and rash, which make the clinical diagnosis of atopic dermatitis 5
Diagnosis and Treatment
Diagnosis of infected dermatitis rash is often clinical, with other eczematous rashes, including autoeczemitization and contact dermatitis, considered in the differential diagnosis list 3. Treatment centers on topical antibiotics and soaks 3, as well as topical corticosteroids and calcineurin inhibitors for refractory cases 5, 4. In some cases, systemic steroid therapy may be required for extensive areas of skin involvement 4.