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Images/Instrument in Dermatology/Dermatosurgery
2024
:4;
16
doi:
10.25259/CSDM_270_2023

Autonomic denervation dermatitis

Department of Dermatology, KPC Medical College and Hospital, Kolkata, India
Corresponding author: Anupam Das, Department of Dermatology, KPC Medical College and Hospital, Kolkata, India. anupamdasdr@gmail.com
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Ray D, Chatterjee S, Das A. Autonomic denervation dermatitis. CosmoDerma. 2024;4:16. doi: 10.25259/CSDM_270_2023

A 68-year-old gentleman presented with itchy, scaly, erythematous papules on the medial aspect of the left lower limb [Figure 1]. He was a known case of insufficiently controlled type 2 diabetes mellitus and ischemic heart disease, who underwent coronary artery bypass graft surgery two years back. Recently, he developed itching and oozing over the great saphenous venous area gradually leading to scaling and erythematous papules. There was no history of application of any agent topically. A clinical diagnosis of autonomic denervation dermatitis following saphenous vein graft harvesting was made. The patient was put on halobetasol propionate 0.05%, fusidic acid 2% cream, and emollient (white soft paraffin and liquid paraffin). The pathomechanism behind the development of autonomic denervation dermatitis is not clear. It is proposed that skin incisions may lead to traumatic transections of dermal nerves causing denervation of various autonomic organs of the skin, especially those responsible for sudomotor and vasomotor responses. It is also assumed that the pathomechanics, which are at play in atopic dermatitis get replayed at postoperative incision sites. However, the exact reason is yet to be discovered.[1,2] Liberal application of emollients to maintain the integrity of the skin barrier along with the optimum amount of topical steroids is the mainstay of therapy.

Figure 1:
Eczematous and erythematous papules and scaling over the medial aspect of left lower limb.

Ethical approval

Institutional Review Board approval is not required.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflicts of interest

There are no conflicts of interest.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation

The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.

Financial support and sponsorship

Nil.

References

  1. , , , , . Autonomic denervation dermatitis: A new type of eczematous dermatitis. Clin Dermatol Rev. 2017;1:61-4.
    [CrossRef] [Google Scholar]
  2. , , . Neuropathy dermatitis following surgical nerve injury. Case Rep Dermatol Med. 2011;2011:234185.
    [CrossRef] [PubMed] [Google Scholar]

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