Article explaining the different types of eczema, the causes, symptoms, treatment and prevention
www.bbc.co.uk/health/conditions/eczema1.shtml

 
Definitions
Eczema affects about 10 - 20 per cent of schoolchildren
The word 'eczema' comes from Greek words that mean 'to boil over'.  Dermatitis comes from the Greek word for skin and both terms refer to exactly the same skin condition.  For simplicity eczema is the term generally used here, although the two words are interchangeable.

• Eczema is an itchy inflammation of the skin associated to a varying degreewith other features such as:
•  Redness of affected areas of skin
• Generally dry skin, which is often thickenedin the areas that have been scratched
• Lumps or blisters in affected areas
• Signs of superficial infection such as weeping or crusty deposits
• Eczema is divided into a small number of subgroups based largely on the factors that may be most important in causing eczema in any one individual, but it is most important to recognise that the symptoms and appearance of the skin in all these types can be exactly the same.

 A useful extra way to classify eczema is based on the degree of activity and for how long the eczema has been active.

Acute
‘Acute’ in medical language means of rapid onset. Often conditions that come on over a short period of time are also quite vigorous in their activity, although strictly speaking ‘acute’ should not be taken to be another word for ‘severe’.

Acute eczema would therefore be an area that recently flared up and would be red, probably also have blisters and possibly some oozing or crusts.

Chronic
‘Chronic’ properly means long-standing. Once the initial phase of activity has died down a bit of skin that has been eczematous for a while is dry, scaly, thickened and cracked.

Infected
At any stage of eczema it can become infected. This won’t always be obviously different from acute eczema unless there are pus-filled blisters.

With experience one can usually discern the golden crust of infection and pick up the other clues that suggest infection.

Based on a text by Dr Dan Rutherford, GP

This is very common occurring in about 10% of women and 4% of men. Hand eczema, also known as hand dermatitis, starts most commonly with mild dryness and some redness. Scaling can increase leading to fissuring and crusting. Initially the fingers and web spaces are involved.  It can be very itchy. Hand dermatitis is often difficult to treat effectively.

It is most commonly seen in those who do a lot of wet work either at home or at work. This condition can be very disabling and can affect the ability to perform at work and home. Homemakers, parents with small children, bartenders, hairdressers, dental workers and surgeons are at risk. The common feature is repetitive wetting and drying of the hands. Cold weather can aggravate the condition. The hands of parents with newborns worsen usually after 3-6 months.  Of those with atopic eczema in childhood about 40% will experience irritant hand dermatitis.  About 70% of these individuals will have hand involvement if their work involves regular contact with hand irritants.

 The Itch That Rashes

Eczema has been called 'the itch that rashes'.  In reality the features of eczema come about in part from the scratching of the skin as a result of the itching.  This itching is usually very severe in atopic eczema and leads to discomfort, agitation and frequent interruption or loss of sleep.

The dry skin in someone with eczema itches, the itching will lead to scratching of the skin.  Scratching not only has a significant effect on the appearance of the involved skin, but will also further damage the skin barrier and will provoke the release of pro-inflammatory mediators such as cytokines that make the itching worse. Scratching may well produce breaks in the skin, which in turn, produce erosions (superficial skin ulcers) and excoriations (scratch marks which break the skin surface).  Breaks in the skin or lesions are also itchy and leads to a vicious itch-scratch cycle being set up which increases the risk of secondary infection which is most frequently caused by the bacteria Staphylococcus aureus.

Repeated rubbing of the skin will in time cause the skin to thicken.  This will produce thickening of the epidermis, thickening of the epidermis will produce increased skin markings, the appearance of which is called lichenification.  This is particularly seen in the flexures in front of the elbows and behind the knees. There is a criss cross pattern to the thickened skin which is very distinctive and easily recognised.