AKA: Eczema craquelé / Xerotic eczema / Winter eczema
• Inflammatory dermatitis developing on markedly xerotic skin due to impaired epidermal barrier function and excessive water loss from the stratum corneum.
• Characterized by a distinctive “cracked porcelain,” “crazy paving,” or “dried riverbed” appearance created by a network of superficial fissures.
• Most common in older adults.
• Typically worsens during winter, when environmental humidity is low and indoor heating further dries the skin.
• Predisposing factors include frequent or hot bathing, harsh soaps and detergents, low humidity, and direct heat exposure.
• Medications associated with xerosis include diuretics and systemic retinoids.
• Less commonly, severe or newly acquired disease may accompany hypothyroidism, malnutrition, significant weight loss, acquired ichthyosis, or systemic disease.
