TAILIEUCHUNG - Chapter 053. Eczema and Dermatitis

Eczema is a type of dermatitis and these terms are often used synonymously (atopic eczema or atopic dermatitis). Eczema is a reaction pattern that presents with variable clinical findings and the common histologic finding of spongiosis (intercellular edema of the epidermis). Eczema is the final common expression for a number of disorders, including those discussed in the following sections. Primary lesions may include erythematous macules, papules, and vesicles, which can coalesce to form patches and plaques. In severe eczema, secondary lesions from infection or excoriation, marked by weeping and crusting, may predominate. In chronic eczematous conditions, lichenification (cutaneous hypertrophy and. | Chapter 053. Eczema and Dermatitis Eczema is a type of dermatitis and these terms are often used synonymously atopic eczema or atopic dermatitis . Eczema is a reaction pattern that presents with variable clinical findings and the common histologic finding of spongiosis intercellular edema of the epidermis . Eczema is the final common expression for a number of disorders including those discussed in the following sections. Primary lesions may include erythematous macules papules and vesicles which can coalesce to form patches and plaques. In severe eczema secondary lesions from infection or excoriation marked by weeping and crusting may predominate. In chronic eczematous conditions lichenification cutaneous hypertrophy and accentuation of normal skin markings may alter the characteristic appearance of eczema. Atopic Dermatitis Atopic dermatitis AD is the cutaneous expression of the atopic state characterized by a family history of asthma allergic rhinitis or eczema. The prevalence of AD is increasing worldwide. Some of its features are shown in Table 53-1. Table 53-1 Clinical Features of Atopic Dermatitis 1. Pruritus and scratching 2. Course marked by exacerbations and remissions 3. Lesions typical of eczematous dermatitis 4. Personal or family history of atopy asthma allergic rhinitis food allergies or eczema 5. Clinical course lasting longer than 6 weeks 6. Lichenification of skin The etiology of AD is only partially defined but there is a clear genetic predisposition. When both parents are affected by AD 80 of their children manifest the disease. When only one parent is affected the prevalence drops to slightly over 50 . Patients with AD may display a variety of immunoregulatory abnormalities including increased IgE synthesis increased serum IgE and impaired delayed-type hypersensitivity reactions. The clinical presentation often varies with age. Half of patients with AD present within the first year of life and 80 present by 5 years of age. About 80 ultimately .

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