Asteatotic eczema (winter itch)

• This often unrecognised problem, which can be very itchy, is a disorder of the elderly. 
• It is a form of eczema that typically occurs on the legs of the elderly 
• Other predisposing factors include
  1. low humidity (winter, central heating)
  2. diuretics
  3. malabsorption state
  4. hypothyroidism
  5. drugs, e.g. statins, diuretics

©DermNet NZ www.dermnetnz.org 2022

CLINICAL FEATURES

1. Dry skin
2. Fine scaling and red superficial cracking
3. ‘Crazy paving’ appearance
4. Occurs on legs, especially shins
5. Also occurs on thighs, arms and trunk

TREATMENT

• Based on correcting dry skin:
  1. Quick, cool showers (<2-3 minutes)
  2. Use soap-free substitutes in the shower
  3. Liberal use of emollients on damp skin, after the shower, e.g. QV or emulsifying ointment
  4. Avoid excessive heating in winter
  5. Avoid use of electric blankets
• Apply topical steroid diluted in white soft paraffin to reddened skin