Asteatotic eczema (eczema craquelé, xerotic eczema) is typically associated with cutaneous loss of lipids, resulting in xerosis of the skin secondary to transepidermal water loss, most commonly seen during the winter months.

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Aetiology

More common in older individuals:

• Disappearance of the lipid film that surrounds the cells in the stratum corneum due to:
  • Age-dependent decrease in sebaceous and sweat gland activity
  • Deficient formation of membrane-coating granules

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Clinical features

Polygonal erythematous fissures separating plates of dry scaly skin, sometimes described as “cracked porcelain,” “crazy pavement,” or a “dry riverbed” appearance.