Symptoms of Dermatitis

Every type of dermatitis shares one headline: ITCH. The rest of the picture - where, how it looks, how it behaves - tells you which type and how angry it is.

The core symptoms

• Itching: usually the first symptom, often worse at night, and the driver of everything else - scratching damages the barrier, which itches more
• Redness and inflammation: pink to red patches (violaceous or grey-brown on darker skin)
• Dryness and scaling: the barrier leaks water; skin turns rough, flaky, cracked
• Small bumps and blisters: in acute flares, tiny fluid-filled vesicles that may weep and crust
• Thickening: with weeks of scratching the skin becomes leathery with deepened lines (lichenification)

Patterns that name the type

• Flexures (elbow and knee folds), face and neck, starting in childhood: atopic pattern
• Exactly where a watch, earring or soap touched: contact pattern
• Scalp, eyebrows, sides of nose with greasy yellow scale: seborrheic pattern
• Lower legs with swelling and brown staining in an older adult: stasis pattern
• Coin-shaped round patches on limbs: nummular pattern

When to see a doctor promptly

• Yellow crusts, pus, fever or rapidly spreading redness: infection on top of the eczema
• Eye involvement: red, painful, light-sensitive eyes in an atopic patient
• Sleep destroyed by itch, or a rash spreading despite two weeks of sensible care

One-line summary

Dermatitis announces with itch, redness, dryness and flaking - weeping blisters in flares, thickened leathery skin after weeks of scratching - and its map (flexures, contact points, scalp, lower legs) names the type, while pus, eye trouble or lost sleep mean the doctor's turn.