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Spongiotic Dermatitis - Symptoms and Treatment

written by: Cordie Kellerman • edited by: Leigh A. Zaykoski • updated: 1/31/2010

Spongiotic dermatitis is a skin condition that causes an extremely itchy rash and the potential for permanent scarring. Learn about its symptoms, treatment and the prevention of flare-ups.

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    Spongiotic dermatitis is a skin condition often referred to as acute eczema. It is a fairly common diagnosis of dermatitis. Sufferers experience intense itching that, if not controlled, can lead to infection and scarring.

    The first manifestation of this condition sometimes occurs at a very young age, especially as a form of diaper rash. It is seen more often in males than females (of any age). Typically, it develops in the areas of the abdomen, chest or buttocks. It is unusual to see it on the head or scalp. There is believed to be a hereditary component to this condition.

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    The first symptom usually noticed is an area of inflammation with severe itching. This is followed by a very noticeable red rash. The rash typically develops fluid filled blisters. As the condition progresses, the rash may darken in color. If left untreated, the color can darken until it appears black and the rash may become rough, crusty and unsightly.

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    Histopathological image of spongiotic dermatitis (Creative Commons GNU Free License A tentative diagnosis can often be made if the symptoms and location are typical for the condition, but for a firm diagnosis, a biopsy must be done.

    To accomplish this, the physician will scrape a small piece of skin from the affected area and send it to a lab for a histological examination (under a microscope).

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    This form of acute eczema is frequently triggered by exposure to allergens or environmental irritants. Food allergies are a common trigger for many patients. Allergies to medications, insect bites, plants, metals or dyes have been reported to cause symptoms. Environmental irritants may include perfumes, smoke, and solvents. Also known to trigger flare-ups are stress, hormone fluctuations, exposure to UVA/UVB sun rays (especially if the patient is photosensitive), and even climate changes.

    Triggers vary for different people and identifying them is key to controlling this condition. Specific triggers can be identified by closely monitoring exposure to suspected triggers and any symptoms that occur. Note that symptoms may not occur immediately and monitoring for hours or even the next few days may be necessary. In the case of possible food allergies, an elimination diet can be very useful.

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    Topical medications are used to reduce itching and inflammation. When these symptoms are controlled, so is their progression and the possibility of scarring is minimized.

    If the itching is not accompanied by significant inflammation or rash, then a menthol-based cream or lotion can be used. If the itching is not controlled by that measure, or if other severe symptoms exist, then a topical corticosteroid may be prescribed. This will address both the itching and the inflammation. If topical treatments are ineffective, a prescription for an oral steroid such as prednisone will probably be given to the patient.

    Some patients report that taking Vitamin A or fish oil has provided relief from symptoms.

    Keeping the affected area moist with any kind of non-irritating lotion or cream is useful in reducing irritation that can lead to a flare-up.

    If the patient is experiencing a blistering rash, it is important to avoid breaking the blisters. The fluid from the blisters is an irritant and will further exacerbate the condition.

    Each flare-up of spongiotic dermatitis is accompanied by the severe itching that can lead to infection and scarring, and it is difficult to bring symptoms under control once they have started. For this reason, the real key to controlling spongiotic dermatitis is to prevent flare-ups in the first place. If food allergies are known to be triggers, then dietary changes to eliminate those foods are very effective. Avoiding known environmental triggers is important. Keeping affected areas moist with lotions and creams can keep mild symptoms from progressing to severe ones.