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Chapter: Clinical Dermatology: Eczema and dermatitis

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Eczema and dermatitis: Clinical appearance

The different types of eczema have their own distin-guishing marks, and these will be dealt with later; most share certain general features, which it is con-venient to consider here.

Clinical appearance

The different types of eczema have their own distin-guishing marks, and these will be dealt with later; most share certain general features, which it is con-venient to consider here. The absence of a sharp mar-gin is a particularly important feature that separates eczema from most papulosquamous eruptions.

Acute eczema

Acute eczema (Figs 7.3 and 7.4) is recognized by its:

   weeping and crusting;

   blisteringausually with vesicles but, in fierce cases, with large blisters;

   redness, papules and swellingausually with an ill-defined border; and scaling.




Chronic eczema

Chronic eczema may show all of the above changes but in general is:

   less vesicular and exudative;

   more scaly, pigmented and thickened;

   more likely to show lichenification (Fig. 7.5)aa dry leathery thickened state, with increased skin markings, secondary to repeated scratching or rubbing; and

   more likely to fissure


Eczema is like jazz; it is hard to defineabut itshould be easy to recognize if you bear in mind the physical signs listed above.

If it does not itch, it is probably not eczema.


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