Eczema

Last reviewed: 7 Jun 2022
Last updated: 08 Feb 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • pruritus
  • xerosis (dry skin)
  • sites of skin involvement
More key diagnostic factors

Other diagnostic factors

  • erythema
  • scaling
  • vesicles
  • papules
  • keratosis pilaris
  • excoriations
  • lichenification
  • hypopigmentation
Other diagnostic factors

Risk factors

  • filaggrin gene mutation
  • age <5 years
  • family history of eczema
  • allergic rhinitis
  • asthma
  • active and passive exposure to smoke
More risk factors

Diagnostic investigations

1st investigations to order

  • clinical diagnosis
More 1st investigations to order

Investigations to consider

  • IgE levels
  • skin-prick testing
  • patch testing
  • skin biopsy
More investigations to consider

Treatment algorithm

ACUTE

acute flare

ONGOING

chronic or relapsing disease (non-refractory)

refractory chronic or relapsing disease

Contributors

Authors

Adelaide A. Hebert, MD

Professor & Director of Pediatric Dermatology

Clinical Specialist

Department of Dermatology and Pediatrics

University of Texas Health Sciences Center in Houston

Houston

TX

Disclosures

AAH serves on the board of the International Hyperhidrosis Society and the American Academy of Dermatology; consults for Pfizer, Galderma, LaRoche Posay, Arcutis, Incyte, Vyne, Varrica, Beiersdorf, Aslan, and Ortho Dermatologics; has undertaken or is undertaking contractual research for Pfizer, Galderma, Ortho Dermatologics, Aslan, Leo, Mayne, Arcutis, Incyte, Verrica, Novan, Brickell, and Almirall; is on the data safety monitoring boards for GSK, Regeneron, and Sanofi; and is on the speakers' bureaux for Pfizer, Almirall, and Galderma.

Eugenio G. Galindo, MD

Dermatology Clinical Research Fellow

UTHealth McGovern Medical School 

Houston

TX

Disclosures

EGG declares that he has no competing interests.

Acknowledgements

Dr Adelaide A. Hebert and Dr Eugenio G. Galindo would like to gratefully acknowledge Dr Quoc-Bao D. Nguyen, Dr Mary D. DarConte, Dr Christina M. Gelbard, and Dr Daniel A. Grabella, previous contributors to this topic. QNN, MDD, CMG, and DAG declare that they have no competing interests.

Peer reviewers

Amor Khachemoune, MD

Assistant Professor

New York University School of Medicine

NY

Disclosures

AK declares that he has no competing interests.

John English, MBBS, FRCP

Consultant Dermatologist

Department of Dermatology

Queen's Medical Centre

Nottingham University Hospitals

Nottingham

UK

Disclosures

JE declares that he has no competing interests.

  • Eczema images
  • Differentials

    • Seborrhoeic dermatitis
    • Irritant contact dermatitis
    • Allergic contact dermatitis
    More Differentials
  • Guidelines

    • Atopic eczema in under 12s: diagnosis and management
    • Atopic eczema in under 12s: diagnosis and management
    More Guidelines
  • Patient leaflets

    Eczema

    More Patient leaflets
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer