LYCOS RETRIEVER 
Dermatitis: Patients
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The cause of nummular dermatitis is not known. It is related to dry skin and is aggravated by wool, soaps, frequent bathing, and many over the counter topical medications. Up to 90% of patients have Staph aureus colonizing the lesions. This suggests that nummular dermatitis may be a hypersensitivity reaction to the bacteria. Alcohol abuse has been reported to be associated with nummular dermatitis, and it may be that alcohol suppresses the immune response making those patients more susceptible to bacterial infection.
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Internal (visceral) malignancies cause about 1 percent of all cases of exfoliative dermatitis.11 Frequently, erythroderma is the presenting sign of the malignancy. Patients with carcinoma of the colon, lung, prostate and thyroid have presented with erythroderma. More recently, carcinomas of the fallopian tube,12 larynx13 and esophagus14 have been reported as causes of exfoliative dermatitis. Insidious development of the erythroderma, progressive debilitation of the patient, absence of previous skin disease and resistance to standard therapy are features that may suggest an underlying malignancy.6,11
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Waikoloa, Hawaii -- Pilot study results indicate that 0.12 percent betamethasone valerate foam is more effective than vehicle alone for short-term stasis dermatitis treatment. "This topical therapy can lead to improved health-related quality of life in these patients," said Alexa Boer Kimball, M.D., assistant professor and director, dermatology clinical trials, Stanford University School of Medicine.
Heat loss is another major concern that accompanies a defective skin barrier in patients with exfoliative dermatitis. Loss of normal vasoconstrictive function in the dermis, decreased sensitivity to the shivering reflex and extra cooling that comes from evaporation of the fluids leaking out of the weeping skin lesions all result in thermoregulatory dysfunction that can cause hypothermia or hyperthermia.6 The basal metabolic rate ... is increased in patients with exfoliative dermatitis. A catabolic state thus ensues, which is often responsible for significant weight loss.
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