Define "eczema"

[CornellDerm]

can anyone define eczema?

Thanks.

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[mystifire]

I swear, I am answering based on my own experience and i did not look up what eczema exactly is on wikipedia or whatever.

Its like, this skin condition where a red rash appears due to irritation or dryness on your skin. It looks different on a lot of people and is treated using steroids or hydrocortisone cream. Lotion can also help calm it.

are you a resident derm? If you are you should know this, I hope that this is like.. a survey or something to see "if" we know it correctly.

 

[CornellDerm]

i am a pathology resident and future dermatopathologist. i am aware of the current definitions of eczema in all the major dermatology texts. i am in no way quizzing the dermatologists.

nonetheless, i find the concept of eczema somewhat elusive (a waste basket diagnosis, if you will). i am just wondering if any gifted dermatologist out there can conceptualize or define eczema in a more meaningful way.

there have been articles published by one very famous (and controversial) dermatologist/dermatopathologist (such as in 1994) recommending that the term "eczema" be abandoned. He and I are currently re-evaluating "eczema" circa 2007 to see if anything has changed.

Thanks for your response.

 

[LurkNoMore]

http://en.wikipedia.org/wiki/Eczema... I'm not being cheeky, I agree with you wholeheartedly as an ms4 going in to derm that the term is used often and has some blurry lines about it... saying "eczema" or "eczematous process". In my simple mind I think of it as a relatively superficial (epidermal) process (maybe a bit of dermal swelling) ranging from erythema, to some superficial scale, but obviously different than something along the lines of psoriatic disease. As you can see from the wiki article, it is really the overlying catch all phrase for innumerable disease states, so it is not a very specific dx. Good luck with dermpath...

 

[mgo737]

In Latin, or Greek (can't remember which), Eczema translates to: "to boil over." In other words, any rash that has poorly-defined margins can be considered eczema. Poorly-defined, meaning it is difficult to determine where the rash begins and ends. In contrast, psoriasis is a remarkable sharply defined rash that is not inherently a type of eczema. However, psoriasis can be eczematized, as can any other rash, with scratching... So basically, anything that is scratched turns into eczema... Interestingly enough, atopic dermatitis, often called eczema, typically starts in the acute phase w/ sharply defined vesicles or papules. Due to the intensely pruritic nature, though, it is quickly scratched and transformed into a poorly-defined rash, or eczema... Hope that helps...

 

[CornellDerm]

Thank you for your contributions.

It is somewhat entertaining that such an elusive entity appears on the menu in some systemic syndromes, such as Wiskott-Aldrich and IPEX. Perhaps these syndromes can shed some light on the immunopathogenesis of eczema.