Spongiotic Dermatitis: Meaning, Causes, Symptoms, Treatment, When to See Doctor

Key takeaways:

• Spongiotic dermatitis is an inflammation of the skin that causes swollen, red, itchy and cracked skin.
• There is no definite cure for spongiotic dermatitis. However, doctors often recommend treatments like medications, topical creams and ultraviolet light therapy to manage the condition.
• Health experts are not sure what causes spongiotic dermatitis. However, they believe that environmental and genetic factors may play a role in its development.

Dermatitis is a broad term used to describe skin inflammation that causes symptoms like skin rashes and irritation. It is a common condition that can affect both children and adults.

There are different types of dermatitis, including atopic dermatitis (eczema), contact dermatitis, diaper dermatitis, and seborrheic dermatitis.

Spongiotic dermatitis occurs in different skin conditions and is commonly associated with eczema, which affects an estimated 16 million adults in the United States. However, it is often a minor skin irritation that can be treated. 

Meaning of spongiotic dermatitis

Spongiotic dermatitis is a type of dermatitis that is characterized by the buildup of fluid under the skin, causing swelling between the cells of the skin.

Even though spongiotic dermatitis is an inflammatory disorder, its hallmark is the presence of intercellular edema of the epidermis (swelling of the cells that line the outer layer of the skin).

This condition causes red, itchy, dry, and cracked skin. It is often considered a form of acute eczema because it is commonly associated with eczema.

Depending on the cause, spongiotic dermatitis symptoms may clear up quickly, or they may last for longer. Your doctor will treat you based on the underlying cause. Also, the condition is not contagious, so there is no risk of person-to-person transmission.

Meaning of spongiosis

The term “spongiotic” is derived from the word “spongiosis,” which means the accumulation of fluid in the outer layer of the skin (the epidermis).

Pathologists use spongiosis to describe the way cells that line the epidermis look when they are swollen and have been pushed apart by fluid.

Spongiotic dermatitis with eosinophils

Spongiotic dermatitis with eosinophils is a skin reaction pattern that occurs when eosinophils, which are a specialized type of white blood cells that help your body fight infection or an allergic reaction, are present in between the cells of the skin. These can only be seen in a histological examination at a histology laboratory.

Causes of spongiotic dermatitis

There is no “one definitive” cause of spongiotic dermatitis. Scientists believe it is caused by a combination of environmental and genetic or medical factors. But reactions to allergens is one of the most common causes of spongiotic dermatitis.

This condition is most commonly associated with atopic dermatitis, which occurs when the immune system overreacts to allergens or small irritants. It is also associated with contact dermatitis, which occurs when the skin comes in direct contact with an allergen or chemical. 

These conditions have genetic dispositions, tend to run in families, and may also be linked to other health conditions like hay fever and asthma.

With that said, other causes of spongiotic dermatitis include:

• Chemical irritants, such as from soaps and cosmetics
• High stress levels (which cause breakouts)
• Hormonal fluctuations
• Allergic reactions to certain foods or food ingredients
• Drug reactions
• Excess sweating (which can worsen itching and irritation)

What is chronic spongiotic dermatitis?

Spongiotic dermatitis is classified into acute, subacute, and chronic depending on the time of biopsy and the histological features seen.

Chronic spongiotic dermatitis is when the spongiosis (swelling) is mild or absent, but the outer layer of the skin is very thick (hyperkeratosis), there is an increased number of some specialized squamous cells on the skin (acanthosis), and there is an abnormality (parakeratosis) in the horny layer of the skin, which affects keratinization.

Risk factors for spongiotic dermatitis

Some people are at a higher risk of developing spongiotic dermatitis, e.g., people with a family history of allergic conditions. 

Factors that can increase the risk for spongiotic dermatitis include:

• Asthma
• Allergies that run in the family
• Being younger (as certain types of dermatitis, like atopic dermatitis, usually occur earlier in childhood)
• Frequent exposure to chemicals or metals that can irritate the skin
• Being diagnosed with conditions like HIV, which weakens the immune system

Symptoms of spongiotic dermatitis

Typical symptoms of spongiotic dermatitis include:

• Dry skin
• Patchy or scaly skin
• Rashes
• Reddened and inflamed skin
• Blisters and skin lesions
• Itchy skin

Diagnosis of spongiotic dermatitis

Just like other skin conditions, diagnosing spongiotic dermatitis will involve examining the skin. Your doctor will first ask questions regarding the specific symptoms you are having, your family history as well as your lifestyle.

To rule out other skin conditions, they may have to take further steps like doing a patch test or biopsy. A biopsy involves taking a small sample of your skin tissue and examining it under a microscope to check for a spongiotic reaction pattern.

A patch test, on the other hand, is often used to check if a patient has contact dermatitis. It is done by placing a patch that contains an allergen that your doctor suspects is causing your skin inflammation on your skin. If your skin reacts to the allergen, it means they have identified the cause of your skin condition. 

How to treat spongiotic dermatitis

There are different approaches to treating spongiotic dermatitis, which could include the use of medications and home remedies. 

Your doctor will know the best treatment option to recommend for you. But, in most cases, to treat spongiotic dermatitis, healthcare professionals often recommend:

• Taking antihistamines to relieve allergy symptoms
• Applying corticosteroid cream to the affected site
• Taking oral steroids to reduce symptoms
• Eating probiotic-rich diets
• Using creams like calcineurin inhibitors to help the immune system control inflammation
• Following a daily skincare routine that involves moisturizing
• Using ultraviolet light therapy
• Getting enough rest 

When to see your doctor for dermatitis concerns

Inflammatory skin conditions, including spongiotic dermatitis, often cause mild symptoms. They are also often not life-threatening. However, they can make you more self-conscious about your skin. 

The good news is that dermatitis is very much treatable. If you notice signs and symptoms like itchiness, skin redness, rashes, blisters, dry skin, flaking skin, or bumps in hair follicles, it will be a great decision to reach out to your doctor. 

Your doctor will examine you and put you on the best treatment plan. If your skin condition is caused by an underlying problem like an allergy, they will prescribe for you medications to treat the underlying cause alongside the symptoms you are having.