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eczema(ĕk`səmə), acute or chronic skin disease characterized by redness, itching, serum-filled blisters, crusting, and scaling. Predisposing factors are familial history of allergic disorders (hay fever, asthma, or eczema) and sensitivity to contact allergens or certain foods. The condition is often irritated by excessive sweating, exposure to extreme heat or cold, and abnormal dryness or oiliness of the skin. Eczema may occur at any age and in both sexes. It is frequently chronic and difficult to treat, and it tends to disappear and recur. Itching can be extreme and severe, and it can often lead to an emotional disturbance. Treatment usually necessitates the avoidance of all unnecessary skin irritation; creams or lotions containing topical immunomodulators, such as tacrolimus (ProTopic and Eladil), or corticosteroids are sometimes helpful. Care should be taken to avoid secondary infections.
an acute or chronic noncontagious inflammatory disease of the skin, neuroallergic in nature and characterized by various eruptions, a burning sensation, itching, and a tendency to recur. A variety of factors, both external (mechanical, chemical, thermal) and internal (diseases of the liver, kidneys, gastrointestinal tract, endocrine and nervous systems), are conducive to the development of eczema.
Several forms of eczema are distinguished, depending on the cause, site, and nature of the inflammation. True eczema is marked by a sudden onset; multiple sites of inflammation, including the nails; symmetrical location of the foci, which have indistinct contours; and reddening of the skin in the affected area. Other symptoms are the formation of minute blisters, some of which change into pustules or moist spots (hence the obsolete name “weeping lichen”), and later the formation of scales and crusts.
In microbial eczema (perivulnus), the foci are usually arranged asymmetrically, mainly on the upper and lower limbs, and have sharp, irregular contours. The skin near the lesions is bluish red and thickened and has pustular and other eruptions and purulent and bloody crusts. Reddening of the skin, edema, numerous blisters, nodules, pustules, and weeping spots occur, mainly on the palms, soles, and fingers.
Seborrheic eczema, or dermatitis seborrheica, is localized mainly on the scalp, forehead, and chest, behind the ears, around the nose and lips, in the armpits, in the groin, and around the umbilicus. The scalp is red and dry, with many grayish scales and seropurulent crusts on a moist surface. Reddening, edema, and weeping are quite pronounced, and there may be painful cracks. The trunk has clearly yellowish pink desquamative spots, some with tiny nodules in the center.
Treatment, depending on the cause and form of the eczema, includes the use of sedatives (valerian, tranquilizers), vitamins (B1 B6, C), and desensitizing and other agents. Also advisable are special diets, treatment in health resorts, and the local application of lotions, pastes, ointments, and antipruritic agents.
REFERENCESShakhtmeister, I. Ia. Patogenez i lechenle ekzemy i neirodermita. Moscow, 1970.
Kozhnye i venericheskie bolezni, 3rd ed. Moscow, 1975.
I. IA. SHAKHTMEISTER