Conditions in Dermatology: Eczema

Conditions in Dermatology: Eczema

Dermatology is a complicated and difficult specialty with many different conditions that fall under its umbrella, ranging from eczema to psoriasis, acne and more. Today we explore eczema, a catch-all term for a large variety of conditions.


Eczema is a dermatological condition where patches of skin become inflamed, itchy, red, cracked, and rough. Different stages and types of eczema affect 31.6 percent of people in the United States.

Eczema can be triggered by certain foods, including nuts and dairy, and can also be triggered by environmental factors like smoke and pollen. While symptoms vary depending on age, eczema usually includes scaly, itchy patches of skin. Eczema is not a curable condition but is not contagious. Treatment focuses on healing and soothing damaged skin and causing relief for the symptoms. 

Atopic Dermatitis

This is a common disease in children and is known by several names: 

  • Eczema (name most people use)
  • Dermatitis
  • Atopic eczema
  • Atopic dermatitis

Children often get atopic dermatitis (AD) during their first year of life. If a child gets AD during this time, you’ll see dry and scaly patches on their skin; specifically on the scalp, forehead, face and cheeks. The itch is intense, and scratching can lead to a skin infection. Treatment and good skin care can help relieve much of the symptoms. 

Contact Dermatitis

Contact dermatitis is caused by touching something that causes a rash; for example, a health care who develops an allergy to latex and touches their face, causing contact dermatitis there. 

In the case of allergic contact dermatitis, this can be a skin reaction triggered either by allergens that have never affected you before or allergens that have always been a problem for you. 

In the case of irritant contact dermatitis, this skin reaction is triggered by a substance that is usually a problem for people, such as bleach, battery acid, or pepper spray. You can also develop irritant contact dermatitis with repeated, excessive contact with water, soap and foods. People who spend a lot of time with wet hands, such as bartenders, nurses and beauticians, are at risk for this. 

Dyshidrotic Eczema

Dyshidrotic eczema (DE) is known by several names, including: 

  • Cheiropompholyx (affects the hands)
  • Dyshidrosis
  • Dyshidrotic dermatitis
  • Foot-and-hand eczema
  • Pedopompholyx (affects the feet)
  • Pompholyx
  • Vesicular eczema
  • Vesicular palmoplantar eczema

DE is caused when the skin cannot protect itself as well as it should, causing itchy, dry skin and deep-seated, small blisters on their hands or feet. The blisters are often very itchy and painful, and when they clear after two or three weeks, the skin is red, dry and cracked. 

There is no cure for DE. People with DE suffer from flare-ups when the weather gets hotter, when their hands are wet for prolonged periods of time, or when they’re stressed. DE ranges from mild to debilitating depending on the severity of symptoms. For example, a severe flare-up on the feet can impact walking, while a severe flare-up on the hands can make washing oneself or doing dishes a difficult prospect. 

Hand Eczema

WIth hand eczema, the skin on your hands can be thick, dry and scaly. You may have deep, painful cracks in the skin of your hands that even bleed. Symptoms of hand eczema that differentiate it from mere dry skin include: 

  • Dry, chapped skin (often the first sign)
  • Patches of red (or dark brown) irritated skin
  • Scaly and inflamed skin that may itch
  • Burning sensation
  • Itchy blisters
  • Deep, painful cracks
  • Bleeding or weeping skin
  • Crusts, pus, and pain

Anything that irritates the skin can cause hand eczema, even something as simple as water.  Relief requires finding the cause. Treatment involves avoiding the trigger and a moisturizer, barrier repair cream or cortisone cream. Without treatment and preventive measures, hand eczema tends to worsen, so it’s important to see a dermatologist before the condition degrades and becomes more serious. 


Neurodermatitis begins with an itch that develops anywhere on the body: arm, leg, back of the neck, anal and genital areas. The itch is so intense that it can be felt during sleep and wake people out of a sound sleep with the need to scratch. Unlike eczema, psoriasis, and other itchy skin conditions, people tend to develop just one or two itchy patches. 

The cause of neurodermatitis is still unknown, but triggers can increase the risk of developing it. These triggers include: 

  • Injury to a nerve
  • Period of intense stress or emotional trauma
  • Bug bite
  • Tight clothing, especially clothing made of wool or a synthetic fabric like rayon or polyester
  • Dry skin

Nummular eczema

People with this skin problem see coin-shaped (nummular) circles of irritated skin appear, often after a skin injury such as an insect bite or a burn. The patches may range in number from one to many and last for months. This condition is also known by multiple names: 

  • Nummular dermatitis.
  • Nummular eczema.
  • Discoid eczema.

Patches on the skin tend to start as a series of tiny, reddish spots and blister-like sores that then enlarge and grow together, forming a coin-shaped patch. The patches tend to exhibit the following symptoms: 

  • Range in size from smaller than 1 inch to bigger than 4 inches.
  • Occur most often on the legs but also occur on the torso (middle of the body), arms, hands, and feet.
  • Be pink, red, or brown and well-defined.
  • Itch and burn: These symptoms range from very mild to severe. The itch may be worse at night, disturbing sleep.
  • Become crusty after the blisters leak fluid and, after a long time, become scaly.

Stasis dermatitis 

Stasis dermatitis is known by several names, including: 

  • gravitational dermatitis
  • venous eczema
  • venous stasis dermatitis

This skin condition occurs in people with poor blood circulation. Poor blood flow tends to occur in the lower legs, so that’s where stasis dermatitis tends to be seen, in either one or both legs. 

Stasis dermatitis commonly occurs in the lower legs because of the way the blood veins in the legs are set up. These leg veins have one-way valves that push blood up the legs, but as we age, these valves weaken and stop working properly, causing blood to leak out and pool. This is known as “venous insufficiency.”

Just having venous insufficiency does not mean you’ll get stasis dermatitis, but watching for signs and symptoms is important, as treatment and self-care can keep the condition from becoming severe. A sign to watch out for is swelling around the ankle that tends to clear while you sleep and return during the day. Other signs include discolored skin and varicose veins. 

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