Eczema: asteatotic eczema (syn. xerotic eczema, eczema craquele)

LAST UPDATED: Nov 16, 2021

Introduction

Asteatotic eczema is characterised by pruritic, dry, cracked, and fissured skin with a 'crazy pavement' pattern. It occurs most commonly on the shins of elderly patients, but it may be widespread.

This chapter is set out as follows:

Aetiology
History
Clinical findings
Images
Management

Aetiology

The condition is a disorder of the elderly
It is precipitated by the drying effect of a cold winter or excess washing

History

Age - predominantly found in older patients
The skin is sore and itchy

Clinical findings

Distribution

Lower legs but can be widespread

Morphology

The appearance is similar to that of 'crazy paving'
Erythema is often, but not always, present

Clinical Images

Please refer to notes on image rights at bottom of the page with regards to individual image ownership.

Management

Wool clothing should not be worn over affected areas

Bathing should be restricted to twice a week and the emollients should be used as a wash as opposed to a soap (or simply plain water if the patient is more at risk from slipping in a bath / shower)

Copious amounts of ointment based emollients are the main stay of treatment

Topical steroids may be needed if there is a significant inflammatory component

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Image Rights - The PCDS would like to thank Dermatoweb, DermQuest (Galderma), and others who have contributed images. All named individuals and organisations maintain copyright for the relevant images.