This article discusses various phases of dermatitis (also known as eczema) with their causes and management.
Eczema is a group of skin conditions with different causes, but clinically similar presentation. These are defined as a pattern of skin inflammation having characteristic morphologies during its acute, subacute and chronic phases.
In acute phase, there will be erythema or redness, edema or swelling, vesiculation or fluid filled lesions, discharge and crusting.
Subacute phase exhibits hyperpigmentation, scaling and crusting.
In chronic phase, there will be lichenification. It is a combination of thickening, hyperpigmentation and prominent skin markings.
It can be broadly divided into two groups. They are,
Exogenous eczemas could either be irritant or allergic in nature.
1. Irritant Contact Dermatitis:
Irritant contact dermatitis type of eczema is caused by many agents, whose toxins or excretory products cause a variable degree of involvement depending upon their concentration and duration of contact with the skin of everyone exposed to them.
These agents can be any of the following:
2. Allergic Contact Dermatitis:
Some common types of endogenous eczemas are as follows.
1. Atopic Dermatitis:
Atopic dermatitis is a chronic eczema. It is one of the atopic conditions, together with asthma and hay fever, has a heritable tendency.
2. Seborrheic Dermatitis:
There is an excessive sebum secretion in this type of eczema presenting with scaly, itchy lesions over the scalp, nasolabial folds, sternal areas and body folds.
3. Discoid Eczema:
Chronic recurrent discrete coin-shaped red areas covered with exudates and crust over the limbs and trunk of the middle aged due to as yet unknown causative factors. Sometimes, it is very difficult to distinguish discoid eczema from psoriasis.
In this type of eczema, vesicular eruptions are generally seen on the palms or soles. The lesions may be non-inflammatory, chronic and recurrent. The exact cause of pompholyx is not known.
Treatment for Acute Stage:
Normal saline or potassium permanganate (1:10,000 dilution) compresses or soaks are given to wash away serous discharge, crust and debris and it also helps to reduce oozing and inflammation. Calamine lotion should not be used. In case of discharge avoid ointment or cream, corticosteroids in lotion form may be used.
Treatment for Subacute Stage:
When there is no oozing or discharge or in cases of subacute or dry eczemas, corticosteroid cream is to be applied locally twice a day. Local antibiotic cream with or without corticosteroid, is helpful where bacteria is present.
Treatment for Chronic Stage:
When the skin becomes thick or lichenified, occlusive dressing with a corticosteroid ointment is required. Alternatively, a moderately potent corticosteroid ointment can be applied locally two to three times a day. The addition of 3% Salicylic acid to the corticosteroid ointment is beneficial.
For further information regarding eczema and its management, consult an eczema specialist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist/eczema
Last reviewed at:
07 Sep 2018 - 4 min read
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