Introduction

Vascular reaction pattern on skin.

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Classification

Aetiological classification:

• Exogenous eczema:
  • Contact dermatitis
    • Irritant contact dermatitis
    • Allergic contact dermatitis
  • Phytodermatitis (plant-related)
  • Photodermatitis
• Endogenous eczema:
  • Seborrhoeic dermatitis
  • Stasis dermatitis
  • Atopic dermatitis
  • Asteatotic dermatitis
  • Pityriasis alba
  • Discoid/nummular eczema
  • Pompholyx/dyshidrotic eczema

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Pathophysiology

Histopathology:

• Acute eczema: Spongiosis (intraepidermal intercellular oedema)
• Chronic eczema: Acanthosis (thickening of stratum spinosum)

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Clinical features

Morphological patterns:

• Acute phase: Erythema, oedema, vesicles, oozing, crusting
• Subacute phase: Erythema, scaling
• Chronic phase: Lichenification
  • Thickening
  • Hyperpigmentation
  • Exaggerated skin markings

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Management

Topical formuations:

• Acute eczema:
  • Wet compresses
  • Cream formulations
• Chronic eczema:
  • Ointment formulations (occlusive base: greasy base)

Topical drugs:

• Emollients (moisturizers)
• Corticosteroids
• Tacrolimus

Systemic drugs:

• Oral corticosteroids
• Azathioprine
• Cyclosporine