Eczema and dermatitis: Clinical appearance

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.

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