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 (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 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.