Eczema commonly presents with dry, itchy skin.
Typically there is erythema, scaling, vesicles, or lichenification in skin flexures.
Diagnosis is primarily clinical.
First-line treatment is with emollients and topical corticosteroids.
Other options that may be used in patients unresponsive to first-line therapy include topical calcineurin inhibitors, phototherapy, biological agents, or immunomodulatory agents.
Eczema is an inflammatory skin condition characterised by dry, pruritic skin with a chronic relapsing course. It can affect all age groups, but it is most commonly diagnosed before 5 years of age and affects 10% to 20% of children. Patients often have a personal or family history of other atopic diseases such as asthma or allergic rhinitis. Food allergies may occur at increased rates in this population. Eczema can be described as acute or chronic. Acute eczema is used to describe a flare-up of symptoms. Chronic is used to describe the condition when the patient develops signs of chronic inflammation (e.g., lichenification).
History and exam
Adelaide A. Hebert, MD
Professor & Director of Pediatric Dermatology
Department of Dermatology and Pediatrics
University of Texas Health Sciences Center in Houston
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
EGG declares that he has no competing interests.
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.
Amor Khachemoune, MD
New York University School of Medicine
AK declares that he has no competing interests.
John English, MBBS, FRCP
Department of Dermatology
Queen's Medical Centre
Nottingham University Hospitals
JE declares that he has no competing interests.
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