Traveler's Dermatitis: Climate-Induced Skin Eruption
Case at a Glance
A 33-year-old male presents with acute onset of pruritic erythematous patches in bilateral antecubital fossae following travel from temperate to hot, humid climate zones.
Patient's Story
The patient, a frequent traveler, recently journeyed from the cool, cloudy climate of Scotland to significantly warmer regions including Greece and Romania, where temperatures reached 40°C (104°F). Within days of arrival, he developed intensely pruritic skin lesions localized to the inner aspects of both elbows. The pruritus was notably worse during nighttime hours, significantly affecting his sleep quality. He denied any known allergies, recent medication changes, or exposure to new cosmetic products.
Initial Assessment
Physical examination revealed erythematous, slightly raised patches with mild scaling in the bilateral antecubital fossae. The lesions appeared inflamed with evidence of excoriation from scratching. No systemic symptoms were reported. The patient's vital signs were stable, and he appeared otherwise well.
The Diagnostic Journey
Given the temporal relationship with climate change and the characteristic distribution, differential diagnoses included contact dermatitis, atopic dermatitis exacerbation, heat rash, or urticaria. The patient initially self-treated with loratadine 10mg daily for seven days without improvement. He then switched to rupatadine tablets and applied topical dimeindene maleate gel (Fenistil) for symptomatic relief.
Final Diagnosis
Climate-induced contact dermatitis with possible heat-related exacerbation of underlying atopic dermatitis. The sudden exposure to extreme heat and humidity likely triggered an inflammatory skin response in predisposed areas.
Treatment Plan
Recommended treatment included topical hydrocortisone 1% cream applied twice daily to affected areas, along with fragrance-free moisturizer to maintain skin barrier function. Continuation of antihistamine therapy for pruritus control. Patient advised to avoid excessive heat exposure and maintain good skin hygiene.
Outcome and Follow-up
Patient was advised to continue the regimen for two weeks and seek dermatological consultation if symptoms persisted or worsened. Follow-up was recommended to monitor treatment response and adjust therapy as needed.