quency and severity of outbreaks. Though der-
matitis is seldom life-threatening, it can signifi-
cantly interfere with QUALITY OF LIFE. Researchers
continue to explore the causes of dermatitis, look-
ing for ways to suppress symptoms.
Risk Factors and Preventive Measures
The key risk factors for dermatitis are family his-
tory and existing allergies. Preventive measures
focus on minimizing outbreaks and symptoms.
Self-care approaches include
- short, warm (not hot) baths or showers
- mild, detergent-free soaps
- lubricating skin lotions, creams, and oils
- nonrestrictive clothing that allows moisture to
evaporate - restricted sun exposure
- resisting scratching
See also ICHTHYOSIS; IMPETIGO; KERATOSIS PILARIS;
LESION; LICHEN PLANUS; LICHEN SIMPLEX CHRONICUS;
PSORIASIS; RASH; STAPHYLOCOCCAL SCALDED SKIN SYN-
DROME; TINEA INFECTIONS; TOXIC EPIDERMAL NECROLYSIS;
URTICARIA.
dermatofibroma A noncancerous (benign)
tumor that develops in the connective tissue
beneath the SKIN, most commonly on the legs and
occasionally on the arms. Dermatofibromas are
firm, round, and may differ in color from the sur-
rounding skin. Most dermatofibromas cause no
symptoms (other than cosmetic) and require no
medical intervention unless they become tender
or irritated. The dermatologist may opt to remove
or scrape down a dermatofibroma in a location
where it receives repeated trauma such as from
shaving or rubbing against clothing. Dermatofi-
bromas are common in adults.
See also LIPOMA.
diaper rash An irritation of the genitals and but-
tocks in an infant or young child who wears dia-
pers. Diaper RASHmay also affect adults who wear
adult diapers or other incontinence products. Most
diaper rash begins as a reaction to the chemicals in
urine or feces, notably ammonia, that comes into
contact with the SKIN. The skin typically appears
chapped and raw. The involved area is painful and
may crack and bleed. Diaper rash that lasts longer
than three days often reflects an INFECTIONof the
skin, commonly FUNGUS (CANDIDIASIS). Untreated,
persistent diaper rash may develop macerations
that can result in deep ulcerations and CELLULITIS,
requiring medical treatment. Mild to moderate
diaper rash is very common in children who are
not yet toilet trained, with nearly all children
experiencing at least one episode. Diaper rash
often accompanies DIARRHEA. Diaper rash occurs
equally among infants who wear cloth diapers and
who wear disposable diapers.
Home treatment successfully eliminates most
diaper rash. Methods include- frequent diaper changes
- cleansing the skin with gentle soap and warm
water with each diaper change - application of a moisture barrier cream or dia-
per rash product with each diaper change
A doctor should evaluate diaper rash that per-
sists longer than a few days without improvement
after home treatment measures.
See also DERMATITIS; FECAL INCONTINENCE; URINARY
INCONTINENCE.discoid lupus erythematosus (DLE) A chronic
autoimmune disorder, also called cutaneous lupus
erythematosus, in which roughly circular, red-
dened patches (erythematous lesions) form on the
SKIN. The lesions are most common on the face,
back of the neck, scalp, inner lips and mouth, and
outer portions of the auditory (EAR) canals. The
INFLAMMATIONinvolves the epidermis, dermis, and
HAIRfollicles. When the lesions heal they leave
permanent scarring, lightened pigmentation, and
loss of hair (ALOPECIA) in their wake. Outbreaks
may range from localized and sporadic to general-
ized and persistent. Cigarette smoking, heat,
and exposure to sunlight precipitate or exacer-
bate outbreaks in many people who have DLE.
About 5 percent of people who have DLE subse-
quently develop SYSTEMIC LUPUS ERYTHEMATOSUS
(SLE), a generalized autoimmune disorder in152 The Integumentary System