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Spongiotic Dermatitis: Symptoms, Causes, Treatment & Prevention

Spongiotic dermatitis can be termed as a type of dermatitis which is inflammation of the skin. In more clarity, spongiotic dermatitis is the way through which dermatitis develops. The condition makes the skin dry, itchy, red and cracked [1] . Spongiotic dermatitis is the type of dermatitis when fluid build-ups develop in your skin, causing swelling between the cells in your skin. The condition can develop in any part of your body, often in one single spot or widespread. And is associated with atopic dermatitis or eczema as well [2] .

[Source: Medical News Today]

Symptoms Of Spongiotic Dermatitis

The signs of the allergic condition are as follows [3] , [4] :

  • Skin lesions
  • Scaly patches of irritated skin
  • Rashes, especially on the hands, inner elbows, and behind the knees
  • Dandruff that is difficult to get rid of
  • Reddened and inflamed skin from constant scratching
  • Severe itching
  • Blisters resulting from rashes
  • Oozing and infection, after scratching an affected area

In extremely rare cases, spongiotic dermatitis can indicate a type of skin cancer known as cutaneous T-cell lymphoma.

Causes Of Spongiotic Dermatitis

The allergic condition can be a sign of seborrheic dermatitis, eczema, atopic dermatitis and other types of skin allergies and reactions [5] .

The most common causes of spongiotic dermatitis are as follows [6] , [7] :

  • Fungal infection
  • Changes in hormone levels
  • Increased stress levels, which can weaken your immune system and cause skin breakouts
  • Contact with chemicals, certain ingredients in cosmetics, or certain metals in jewellery that can cause severe irritation
  • Allergic reactions, such as to medications or food
  • Changes in temperature or weather conditions
  • Excessive sweating, which can worsen itching

Risk Factors Of Spongiotic Dermatitis

The following aspects are identified as the risk factors pertaining to the condition [8] , [9] .

  • Younger age because spongiotic dermatitis is more common in children than adults (with 10 to 20 per cent of children and 1 to 3 per cent of adults experiencing the condition).
  • Frequent contact with certain metals or chemicals (irritants) such as detergents, chemicals, or metals can trigger the condition.
  • Allergies like hay fever (that is, allergic conditions that run in the family).
  • Pre-existing conditions, like Parkinson's disease, HIV, and heart conditions.
  • Asthma.
  • Insect bites.
  • Family history of atopic dermatitis.

Diagnosis Of Spongiotic Dermatitis

Considering the condition is a way through which dermatitis develops, the doctor will be required to take certain steps to understand the difference between spongiotic dermatitis and other types of dermatitis [10] .

In some cases, the doctor will be able to diagnose the condition by examining the appearance of your skin. But in case of accurate and more precise diagnosis, a skin biopsy will be conducted so as to diagnose the spongiotic tissue in your dermatitis [11] .

Biopsy: Under this diagnosis method, the doctor will remove a small sample of skin, which will be sent to a lab. Skin biopsy can be conducted in three different ways, such as, a excisional biopsy (the doctor will remove a sample of your skin with a scalpel to sample the tissue underneath your skin), shave biopsy (the doctor will remove samples of the top layer of your skin with a razor or similar tool) and punch biopsy (the doctor will remove a sample of the top layer of your skin and the fat just underneath using a tool called a skin punch) [10] , [12] .

The results will take a few days to a few weeks to return. The results may take even longer if more elaborative tests are to be done on the extracted samples.

Biopsy results: Apart from conducting a biopsy, the doctor will use your biopsy tests as a diagnosis method. The biopsy results will help the doctor understand whether the dermatitis tissue is spongiotic. The tissue will is examined for oedema (fluid build-up) and the severity of spongiosis [13] .

Patch test: Under this test, the doctor will apply a small amount of irritant, so as to understand the type of infection. During a follow-up, the doctor will check the skin under the patch to see if you've had an allergic reaction to the irritant. A patch test help determines dermatitis causing substance [14] .

Treatments And Medication For Spongiotic Dermatitis

Analysis and medication for the condition depend on the cause and symptoms. As there is no specific treatment for the condition, the treatment method aims at managing the symptoms [15] , [16] , [17] .

  • Applying topical calcineurin inhibitors will help control the inflammation during flare-ups. These medicines help block the chemical causing the inflammation and reduce redness and itching.
  • Consuming non-drowsy antihistamines help relieve the symptoms of allergies, without causing any drowsiness.
  • Topical steroid creams to ease redness and itching (use the prescribed medication because some topical creams are too strong and can cause thinning of the skin).
  • Taking prescribed oral steroids can help relieve symptoms during severe or widespread flare-ups.
  • Undergoing ultraviolet light treatment or phototherapy will help ease some skin disorders by reducing inflammation. It is not recommended for children.

Lifestyle Changes For Spongiotic Dermatitis

  • Moisturise daily and use soaps with good moisturising contents [18] .
  • Add probiotics to your diet.
  • Take bleach baths.
  • Avoid using shower gel detergents.
  • Try relaxation techniques if stress is making the condition worse.
  • Wash your hair as frequently as possible.
  • Use shampoos containing ketoconazole, selenium, or zinc pyrithione.

Prevention Of Spongiotic Dermatitis

  • Follow a daily skincare routine which includes regular moisturising and using prescribed medications or treatments [18] .
  • Wear non-rubber gloves when doing manual tasks such as housework, to protect the hands.
  • Avoid potential triggers which can include certain types of food, cosmetics or certain animals.

  • Avoid scratching the affected skin as it can lead to further damage or infection.
  • Wear soft and breathable materials, such as cotton; and avoid using itchy fabrics, including wool.
  • Wash clothes with non-biological laundry powder and use double rinse cycle to get rid of the detergent residues.
  • Avoid sweating and getting your skin overheated as it can make itchiness worse.
  • Treat the symptoms as soon as they appear.
View Article References
  1. [1] Hersle, K., & Mobacken, H. (1982). Hyperkeratotic dermatitis of the palms.British Journal of Dermatology,107(2), 195-202.
  2. [2] LeBoit, P. E., & Epstein, B. A. (1990). A vase-like shape characterizes the epidermal-mononuclear cell collections seen in spongiotic dermatitis.The American journal of dermatopathology,12(6), 612-616.
  3. [3] Ackerman, A. B., Breza, T. S., & Capland, L. (1974). Spongiotic simulants of mycosis fungoides.Archives of dermatology,109(2), 218-220.
  4. [4] Emmerson, R. W., & Wilson-Jones, E. (1968). Eosinophilic spongiosis in pemphigus: A report of an unusual histological change in pemphigus.Archives of dermatology,97(3), 252-257.
  5. [5] O'keefe, R. J., Scurry, J. P., Dennersten, G., Sfameni, S., & Brenan, J. (1995). Audit of 114 non‐neoplastic vulvar biopsies.BJOG: An International Journal of Obstetrics & Gynaecology,102(10), 780-786.
  6. [6] Hersle, K., & Mobacken, H. (1982). Hyperkeratotic dermatitis of the palms.British Journal of Dermatology,107(2), 195-202.
  7. [7] Schechner, J. S., Edelson, R. L., McNiff, J. M., Heald, P. W., & Pober, J. S. (1999). Integrins alpha4beta7 and alphaEbeta7 are expressed on epidermotropic T cells in cutaneous T cell lymphoma and spongiotic dermatitis.Laboratory investigation; a journal of technical methods and pathology,79(5), 601-607.
  8. [8] Trautmann, A., Altznauer, F., Akdis, M., Simon, H. U., Blaser, K., Akdis, C. A., ... & Bröcker, E. B. (2001). The differential fate of cadherins during T-cell-induced keratinocyte apoptosis leads to spongiosis in eczematous dermatitis.Journal of Investigative Dermatology,117(4), 927-934.
  9. [9] VESTERGAARD, L., CLEMMENSEN, O. J., Sørensen, F. B., & Andersen, K. E. (1999). Histological distinction between early allergic and irritant patch test reactions: follicular spongiosis may be characteristic of early allergic contact dermatitis.Contact Dermatitis,41(4), 207-210.
  10. [10] Rosa, G., Fernandez, A. P., Vij, A., Sood, A., Plesec, T., Bergfeld, W. F., & Billings, S. D. (2016). Langerhans cell collections, but not eosinophils, are clues to a diagnosis of allergic contact dermatitis in appropriate skin biopsies.Journal of cutaneous pathology,43(6), 498-504.
  11. [11] Frings, V. G., Böer-Auer, A., & Breuer, K. (2018). Histomorphology and Immunophenotype of Eczematous Skin Lesions Revisited—Skin Biopsies Are Not Reliable in Differentiating Allergic Contact Dermatitis, Irritant Contact Dermatitis, and Atopic Dermatitis.The American Journal of Dermatopathology,40(1), 7-16.
  12. [12] Gru, A. A., & Salavaggione, A. L. (2017, May). Common spongiotic dermatoses. InSeminars in diagnostic pathology(Vol. 34, No. 3, pp. 226-236). WB Saunders.
  13. [13] Elbendary, A., Parikh, K., Elattar, I., Truong, J., & Elston, D. M. (2016). Expression of T-bet and GATA-3 in early mycosis fungoides and spongiotic dermatitis.Journal of the American Academy of Dermatology,74(5), 1012-1014.
  14. [14] Billings, S. D., & Cotton, J. (2016). Spongiotic dermatitis. InInflammatory Dermatopathology(pp. 5-21). Springer, Cham.
  15. [15] Phung, T. L., Wright, T. S., Pourciau, C. Y., & Smoller, B. R. (2017). Spongiotic dermatitis. InPediatric Dermatopathology(pp. 1-22). Springer, Cham.
  16. [16] Fertig, R. M., Gaudi, S., Cervantes, J., Maddy, A., Sangueza, O., Vu, J., ... & Jukic, D. M. (2017). Feasibility study in teledermatopathology: An examination of the histopathologic features of mycosis fungoides and spongiotic dermatitis.Journal of cutaneous pathology,44(11), 919-924.
  17. [17] Ji, H., & Li, X. K. (2016). Oxidative stress in atopic dermatitis.Oxidative medicine and cellular longevity,2016.
  18. [18] Emanuel, S., & Hawarden, D. (2018). Dermatitis.Current Allergy & Clinical Immunology,31(3), 164-165.
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