Types of eczema

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Eczema Flexor Surfaces

The many causes of eczema are not consistently related to the distribution and clinical appearance. In general there are either external factors acting on the skin producing inflammatory changes or it is an endogenous condition. It is important to remember there can be more than one cause—for example, in atopic eczema or varicose eczema on the ankle an allergic reaction may develop to the treatments used.

Atopic eczema affects mainly the flexor surfaces of the elbows and knees as well as the face and neck. To a variable degree it can affect the trunk as well.

The typical patient with atopic eczema is a fretful, scratching child with eczema that varies in severity, often from one hour to the next. In the older child or adult, eczema is more chronic and widespread and its occurrence is often related to stress. Atopic eczema is common, affecting 3% of all infants, and runs a chronic course with variable remissions. It normally clears during childhood but may continue into adolescence and adult life as a chronic disease. It is often associated with asthma and rhinitis. Sufferers from atopic eczema often have a family history of the condition.

Variants of atopic eczema are pityriasis alba—white patches on the face of children with a fair complexion—and chronic juvenile plantar dermatosis—dry cracked skin of the forefoot in children. This does not affect the interdigital spaces and is not due to a fungal infection.

Eczema herpeticum. Children with atopic eczema are particularly prone to herpes virus infection, which may be life

Herpes Eczema
Factors leading to development of atopic eczema
Coin Shaped Herpes
Atopic eczema—distribution
Eczema Plantar
Atopic eczema Plantar dermatosis Nummular eczema

threatening. Close contact with adults with "cold sores" should therefore be avoided.

Nummular eczema appears as coin shaped lesions on legs and trunk.

Stasis eczema occurs around the ankles, where there is impaired venous return.

Paget's disease of the breast. Whereas bilateral eczema of the nipples and areolae occur in women, any unilateral, persistent, areas of dermatitis in this region may be caused by Paget's disease, in which there is underlying carcinoma of the ducts. In such cases a biopsy is essential.

Lichen simplex is a localised area of lichenification produced by rubbing.

Neurodermatitis is a term often used synonymously with lichen simplex. It is also used to describe generalised dryness and itching of the skin, usually in those with atopic eczema.

Asteatotic eczema occurs in older people with a dry, "crazypaving" pattern, particularly on the legs.

Pompholyx is itching vesicles on the fingers, with lesions on the palms and soles in some patients.

Infection can modify the presentation of any type of eczema or contact dermatitis.

Asteatotic Distribution
Nummular eczema—distribution

Classification of eczema

Endogenous (constitutional) eczema

Exogenous (contact) eczema

Secondary changes



Lichen simplex

Nummular or discoid








Seborrhoeic (discussed later)


Stasis eczema

Seborrhoeic (discussed later)


Curing Stasis DermatitisEczema Endogeno

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