A case of atopic eczema (atopic dermatitis) can be a child who has chronic and itchy rashes on their skin. Assume Emily, a 2-year-old girl, suffers from atopic eczema:
Emily frequently scratches her skin, especially on her cheeks, elbows, and knees, due to the intense itching caused by the condition. Her skin appears red, inflamed, and dry, with small bumps and patches of rough, scaly skin. The itching worsens at night, affecting her sleep, and she becomes irritable and restless.
Emily’s parents notice that her eczema flares up when she is exposed to certain allergens, such as dust mites or pet dander. They also observe that the rash improves when they apply prescribed emollients (moisturizers) and topical corticosteroids as directed by her pediatrician.
Despite diligently following the treatment plan, Emily experiences occasional flare-ups during certain weather changes or periods of high stress. Her parents continue to work closely with her healthcare provider to adjust her treatment plan as needed and learn about potential triggers to minimize future flare-ups.
Like AD, asteatotic eczema, also known as eczema craquelé or xerotic eczema, has associations with dry skin. However, most skin lesions in asteatotic eczema are in the legs and look like plates of dry skin separated by cracks, showing a distinctive “dry riverbed” appearance. This type of eczema is typically more common in older adults, likely due to skin changes associated with aging.
AD and contact dermatitis go through the three stages of eczema and show similar features. However, with contact dermatitis, a person’s skin experiences irritation or an allergic reaction after contact with a trigger, causing the skin to sting, burn, and become inflamed.
There are many known potential irritants, including hair dyes, nickel, certain antibiotics, preservatives, and chemicals. There are two types of contact dermatitis: irritant and allergic contact dermatitis.
Discoid or nummular dermatitis
Similar to AD, discoid or nummular dermatitis is a long-term condition. It presents with similar symptoms of itchy patches of skin that may sometimes ooze fluid. However, in discoid dermatitis, skin patches have a distinct round shape.
Common triggers can include dry skin, insect bites, chemical burns, and other skin trauma. People with AD and allergic contact dermatitis are also prone to developing discoid eczema.
Dyshidrotic eczema, which some health experts call pompholyx, causes small, itchy, and painful blisters to develop on the soles of the feet and palms of the hand.
Similar to AD, this condition tends to run in families. Dyshidrotic eczema is more common in adults aged under 40 years and females. Some people only have a single flare-up, but a majority can have it over the long term. Common triggers may include allergies, hot weather, moist hands, stress, and exposure to metals.
While AD and neurodermatitis can result in itchy lesions, skin thickening (lichenification), and discoloration, lesions in neurodermatitis are usually limited to one or two patches of skin. Itchy patches can develop anywhere but commonly appear on the feet, ankles, wrists, elbows, scalp, back of the neck, and groin area.
Neurodermatitis, which doctors call lichen simplex chronicus, develops when a person scratches an itchy skin patch. These lesions are often very itchy, while scratching may cause bleeding and scarring.
Seborrheic dermatitis affects skin areas that produce a lot of oil, including the scalp, nose, and upper back. The skin can appear swollen and greasy, while crusty scales may appear. The skin condition is due to an overproduction of Malassezia yeast, which causes an overreactive immune response, leading to skin inflammation.
It can occur in infants, known as cradle cap, and in adults. In infants, it often resolves by itself and does not come back. However, it often persists in adults and may come and go.
Varicose or stasis dermatitis
Also called stasis dermatitis, venous eczema, and gravitational dermatitis, this condition usually affects people with reduced circulation. While it is more common in older adults and women, it can also occur in young people with a predisposition to developing varicose veins. Aside from varicose veins, an individual with this skin disorder may notice ankle swelling and skin discoloration due to blood vessel bursting. It can also cause ulcers.
This example illustrates a typical presentation of atopic eczema in a young child. Atopic eczema can manifest differently in individuals, but the common characteristics include itching, redness, inflammation, and a chronic or relapsing course. Proper management, identification of triggers, and adherence to prescribed treatments are essential to help individuals like Emily achieve better control over their atopic eczema and improve their quality of life.