Thinking Through Diagnostic Challenges in Patients with Eczema: Considerations and Pitfalls Part 1

In episode 51 of Derms and Conditions, our host James Q. Del Rosso, DO, sits down with Matt Zirwas, MD, a dermatologist in Columbus, Ohio, and founder of the Bexley Dermatology Research Clinic. The two discuss how to approach a patient with an unspecified dermatitis. Dr. Zirwas begins by recounting his experiences with dermatitis unspecified, also known as non-atopic adult dermatitis, and how he became interested in treating this complex disease. Dr. Del Rosso asks how to differentiate between this disease and other similar diagnoses, prompting Dr. Zirwas to share his method for recognizing the many types of eczema and contact dermatitis. Patients that receive this diagnosis often want to know what caused it and how it can be prevented. While the answer is not always clear, Dr. Zirwas provides his tips for counseling patients on possible triggers. This can include the food that they eat and its effect on the microbiome, as well as the many products they apply to their skin. Dr. Zirwas has plenty of suggestions for products with low allergenicity that these patients can try. Finally, the two discuss the role nickel plays in contact dermatitis and how to differentiate between atopic dermatitis, allergic contact dermatitis, and irritant contact dermatitis. This episode is full of pearls for one of the trickiest diagnoses in dermatology, so tune in to learn more!