Eczema, rash, erythema or dermatosis: let's talk about our skin

By Cristiano Antonino On May 5, 2023

Eczema, more commonly known as simple dermatitis, is one of the most common skin diseases: it manifests itself as an inflammation of the skin, characterized by skin rashes, itching sensation, redness and possible formation of blisters or crusts in the affected area

The causes can be linked to different factors and the treatment of this disorder varies according to the individual specific case.

There are different types of dermatitis, therefore, a specialist consultation is necessary for a correct diagnosis.

Among the most common ones we find: atopic eczema, contact dermatitis, seborrheic eczema or asteatotic eczema.

What is an eczema

Eczema is a fairly common inflammation of the skin generally characterized by itching, erythema and more or less extensive skin rashes, with or without the presence of vesicles or crusts.

It is a disorder that can occur both in a mild and transient form and in a chronic form.

The causes can be of different nature and the skin lesions can be located in any area of the body.

Eczema, whatever its origin, is not contagious.

In recent years, the incidence rate of eczema has increased exponentially and this disorder can affect patients of any gender and age, although children are generally the most affected subjects.

What are the main causes

The factors responsible for the onset of eczema can be of different nature.

Whatever the cause behind the formation of these, the triggering effect is always an inflammatory process of the dermis.

In general it would seem that dermatitis derives from a combination of both environmental and genetic factors:

environmental factors or exposure to irritants, bacteria or fungi can be the cause of allergic reactions.
Patients with specific gene modifications are also predisposed to this condition. The genetic hypothesis has been supported by many studies on subjects from the same family nucleus.

Symptoms and complications

The clinical manifestation of dermatitis, regardless of the factors that generated it, is always represented by:

rash (exanthema) more or less extensive and localized in one or different areas of the body
Appearance of blisters, crusts or pus (in more advanced cases)
Erythema and swelling of the affected area
Itching and irritation
Skin dryness
Flaking

Eczema cannot give rise to particular complications, however it is good to promptly treat the inflammation to avoid any scratching injuries which can favor bacterial over-infections.

Eczema diagnosis

In most cases, there are no specific tests for diagnosing eczema.

It is usually possible to contact a dermatologist to identify the cause of the disorder: by carrying out a general examination of the lesion and thanks to an accurate patient history, the professional will thus be able to determine a diagnosis and possibly a therapy.

To determine the allergic origin of eczema it is useful to make use of the following diagnostic means to support the patient’s clinic.

patch-test and/or prick-test to identify any sensitivity to certain substances
blood tests to search for specific antibodies against particular allergens

Types of eczema

As mentioned above, depending on their origin, dermatitis can be of different types.

Among the most common forms of eczema are: atopic eczema (AD), contact eczema (AD), seborrheic eczema and asteatotic eczema.

Less widespread and secondary to other underlying pathologies, among the dermatitis we also find: discoid eczema, dermatitis herpetiformis, stasis dermatitis and perioral dermatitis.

Atopic eczema

Eczema of atopic origin is very common and is one of the forms of dermatitis with the highest incidence, especially in children.

People already suffering from allergic asthma or hay fever are particularly predisposed.

The use of aggressive products, chemical agents and rough clothes, or prolonged exposure to dust mites and other allergens can favor the onset of atopic dermatitis.

Contact dermatitis

Contact dermatitis is a skin inflammation due to contact with particular substances, many of which are harmless to most people.

In some subjects, however, they can cause redness, swelling and rashes.

It can be allergic (caused by direct contact with some allergens) or irritative (caused by exposure to highly irritating substances or to which the subject is particularly sensitive).

Some of these agents are: nickel, poison ivy, Peru balsam cosmetics, etc.

The affected areas are those that have come into contact with the substance in question (generally the hands or face).

The rush is accompanied by persistent itching and dry skin that tends to flake.

Seborrheic eczema

Seborrheic eczema is a condition that mainly affects the scalp and can sometimes also extend to the eyebrows, chest, area around the nose and groin and in general in all areas rich in sebaceous glands.

It is characterized by skin rashes in the form of greasy flakes, such as dandruff.

The cause is multifactorial.

Asteatotic eczema

Asteatotic eczema (xerosis) is a skin inflammation whose main symptoms are dryness and thickening of the skin.

It is a typical disorder of old age and is usually localized at the level of the limbs and trunk.

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Uncommon dermatitis

Dyshidrosis: dyshidrotic or pompopholix eczema is a chronic dermatitis with acute and recurrent manifestations and mainly affects the hands and feet. It is represented by the appearance of often itchy blisters on the surface of the hands and feet.
Discoid eczema: discoid or nummular eczema is a particular type of dermatitis characterized by the presence of itchy, round or oval, red-brownish lesions. The areas of the body most affected are the forearms, hands and feet, legs and trunk.
Varicose eczema or stasis dermatitis: this is a disorder that generally affects patients with circulatory diseases and elderly people. Symptoms include redness in the leg area, itching, scaling and dark patches and is due to venous stasis underneath the skin.
Dermatitis herpetiformis: is of autoimmune origin and is characterized by papulo-vesicular rash. It is chronic, intensely itchy, and strongly associated with celiac disease. Typical manifestations are urticarial, erythematous, clustered lesions as well as vesicles, papules, and bullae usually distributed symmetrically on the surfaces of the limbs, back, or corners of the mouth.
Perioral dermatitis: rash mainly around the mouth mainly due to the use of fluoride-based toothpastes, oral contraceptives, some cosmetics and detergents, exposure to cold.

Treatment

As already highlighted, the most effective therapy for treating eczema varies greatly according to the type of disorder.

Usually the treatment of this pathology involves the use of emollients and some specific drugs for oral administration or for topical use.

They understand:

Corticosteroids to fight inflammation
Immunosuppressants that aim to reduce the immune system in order to limit the inflammatory response triggered by dermatitis
Antibiotics to take in case of bacterial infections
Antihistamines that block the release of histamine (a compound produced by the body in case of inflammation) that triggers itching and irritation

In some cases, phototherapy sessions may be prescribed

In the case of purulent crusts, the use of detergents based on salicylic acid, selenium or zinc to disinfect the skin may be indicated
Subjects with a particular predisposition to the manifestation of any form of dermatitis should:

Keep the skin clean and hydrated using neutral cleansers and creams

Avoid the use of any chemical agent in the acute period of the rush, limiting yourself to the use of water to wash the affected area

Wear light, loose-fitting clothes made of natural fibers such as cotton, while avoiding wool and synthetic fibers

However, it is important to remember that there is no real definitive cure for eczema: the therapy mainly aims to eliminate or mitigate the symptoms that accompany the acute manifestations.

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