Asteatotic Eczema (Eczema Craquelé)

Eczema Craquelé / Crazy Paving Eczema

Overview

Asteatotic eczema (eczema craquelé) is a common form of dermatitis that occurs when the skin becomes excessively dry, leading to a characteristic cracked, fissured pattern resembling dried mud or crazy paving. It is most common on the shins of elderly patients during winter months. The condition results from a breakdown of the skin barrier due to loss of natural oils and moisture.

Key Symptoms

• Dry, cracked skin with a distinctive 'crazy paving' or dried mud-bed pattern of fissures
• Superficial red fissures on a background of dry, scaly skin
• Predominantly affects the shins, though can spread to thighs, arms, and trunk
• Itching that may range from mild to severe
• Skin may become inflamed, red, and weepy if secondary eczema develops
• Symptoms worsen in cold, dry weather and with excessive bathing

Affected Areas

Shins (most common), Thighs, Arms, Trunk, Flanks

Care Instructions

1. Moisturize frequently with thick, fragrance-free emollients or ointments, especially after bathing.
2. Take short, lukewarm baths or showers; avoid hot water which strips natural skin oils.
3. Use gentle, soap-free cleansers instead of regular soap.
4. Apply topical corticosteroids to inflamed or itchy areas as directed by your dermatologist.
5. Use a humidifier in the home during dry winter months.
6. See a dermatologist if the condition does not improve with moisturizing, if it spreads, or if signs of infection develop.

Medical Disclaimer: This information is for educational purposes only and does not replace professional medical advice. Always consult a qualified dermatologist for diagnosis and treatment.

Prevalence: Very common in the elderly; one of the most frequent dermatologic conditions in patients over 60