Eczema

What is Eczema?

Eczema is a group of unrelated diseases that have a similar appearance. When it is new eczema, the affected skin appears red and elevated with small blisters (vesicles) containing a clear fluid. When the blisters break, the affected skin will weep and ooze (exude).

In older eczema, chronic eczema, the blisters are less prominent and the skin is thickened, elevated, and scaling. Eczema almost always is very itchy.

Symptoms

Eczema includes dryness and recurring skin rashes that are characterized by one or more of these symptoms: redness, skin edema (swelling), itching and dryness, blistering, cracking, oozing, or bleeding. Causes

The most common type of eczema - atopic dermatitis -- resembles an allergy. The current thinking is that eczema is caused by a combination of factors that include:

  • activities that may cause skin to be more sensitive
  • defects in the skin barrier that allow moisture out and germs in
  • abnormal function of the immune system
  • genetics
  • environment

An accurate diagnosis requires an examination of the entire skin surface and a careful history. It is important to rule out curable conditions caused by infectious organisms. Occasionally, a sample of skin (biopsy) may be sent for examination in a laboratory. If allergies are suspected, patch testing (not scratch or prick testing) may be required.

Treatment

Corticosteroids are highly effective in controlling or suppressing symptoms in most cases. For mild-moderate eczema a weak steroid may be used (e.g. hydrocortisone), while in more severe cases a higher-potency steroid (e.g. clobetasol propionate) may be used. In severe cases, oral or injectable corticosteroids may be used.