Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Rather than a specific condition, eczema is a group of
unrelated diseases that have a similar appearance. When it is new eczema, the
affected skin appears red and elevated with small blisters (vesicles) containing a clear
fluid. When the blisters break, the affected skin will weep and
ooze. In older eczema, chronic eczema, the blisters are less prominent and the skin
is thickened, elevated, and scaling. Eczema almost always is very itchy.
Are there different types of eczema?
There are at least 11 different types of
skin conditions that produce eczema. In order to develop a rational treatment
plan, it is important to distinguish them. This is often not easy.
What causes eczema?
Atopic dermatitis: This condition has a genetic basis
and is probably most commonly called eczema. Atopic dermatitis tends to begin
early in life in those with a predisposition to inhalant allergies, but it
probably does not have an allergic basis. Characteristically, rashes occur on the
cheeks, neck, elbow and knee creases, and ankles. Rarely, a few those with
atopic dermatitis can get an extensive herpes simplex infection called "eczema herpeticum."
Irritant dermatitis: This occurs when the skin is repeatedly exposed
to toxic substances.
Allergic contact dermatitis: After repeated exposures
to the same substance, the body's immune recognition system becomes activated at
the site of the next exposure and produces eczema.
It commonly occurs on the swollen lower legs of people who have poor circulation
in the veins of the legs.
Fungal infections: This can produce a pattern identical
to many other types of eczema, but the fungus can be visualized with a scraping
under the microscope or grown in culture.
Scabies: It's caused by an infestation
by the human itch mite and may produce a rash very similar to other forms of eczema.
Pompholyx (dyshidrotic eczema): This is a common but poorly understood condition
which classically affects the hands and occasionally the feet by producing an
itchy rash composed of tiny blisters (vesicles) on the sides of the fingers or
toes and palms or soles.
Lichen simplex chronicus: It produces thickened plaques of skin
commonly found on the shins and neck.
Nummular eczema: This is a nonspecific term
for coin-shaped plaques of scaling skin most often on the lower legs of older
Xerotic (dry skin) eczema: When the skin becomes
pathologically dry, it will crack and ooze.
Seborrheic eczema: It produces a
rash on the scalp, face, ears, and occasionally the mid-chest in adults. In
infants, in can produce a weepy, oozy rash behind the ears and can be quite
extensive, involving the entire body.