Eczema vs. Atopic Dermatitis

Eczema is a nonspecific term for many types of skin inflammation (dermatitis). There are different categories of eczema, which include allergic, contact, irritant, and nummular eczema, which can be difficult to distinguish from atopic dermatitis. These types of eczema are listed and briefly described below. Atopy is a medical syndrome that includes three associated conditions that tend to occur in the same individual: atopic dermatitis, inhalant allergies, and asthma. All three components need not be present in the same individual simultaneously.

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Quick GuideEczema (Atopic Dermatitis) Causes, Symptoms, Treatment

• Eczema is not a single health condition but a recognizable reaction pattern seen in a number of skin diseases.
• Atopic dermatitis, a common causes of eczema, is more prevalent in those with asthma and hay fever.
• Eczema signs and symptoms include tiny blisters (vesicles) that can weep and ooze, eventually producing crusted, thickened plaques of skin. It is almost always quite itchy.
• It is important to distinguish the different causes of eczema because effective treatments often differ.
• If eczema is produced by skin exposure to a specific substance, it can be helpful to avoid it.
• Keeping the skin healthy and moisturized can prevent certain kinds of eczema.

Rather than a specific health condition, eczema is a reaction pattern that the skin produces in a number of diseases. It begins as red, raised tiny blisters containing a clear fluid atop red, elevated plaques. 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.

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.

1. Atopic dermatitis: This health condition has a genetic basis and produces a common type of 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.
2. Irritant dermatitis: This occurs when the skin is repeatedly exposed to excessive washing or toxic substances.
3. Allergic contact dermatitis: After repeated exposures to the same substance, an allergen, the body's immune recognition system becomes activated at the site of the next exposure and produces eczema. An example of this would be poison ivy allergy.
4. Stasis dermatitis: It commonly occurs on the swollen lower legs of people who have poor circulation in the veins of the legs.
5. 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.
6. Scabies: It's caused by an infestation by the human itch mite and may produce a rash very similar to other forms of eczema.
7. Pompholyx (dyshidrotic eczema): This is a common but poorly understood health 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.
8. Lichen simplex chronicus: It produces thickened plaques of skin commonly found on the shins and neck.
9. Nummular eczema: This is a nonspecific term for coin-shaped plaques of scaling skin most often on the lower legs of older individuals.
10. Xerotic (dry skin) eczema: The skin will crack and ooze if dryness becomes excessive.
11. Seborrheic dermatitis: 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.