Eczema : Symptoms, Diagnosis and Management

Eczema : Symptoms, Diagnosis and Management

Eczema is often referred to as atopic dermatitis. The term eczema is broadly applied to a range of persistent skin problems. These symptoms include dryness and skin rashes that are characterised by one or more of symptoms like:

  • Scratching
  • Redness
  • Flaky skin

Atopic dermatitis is also known as infantile eczema, when it occurs in infants. Infantile eczema may extend into childhood and adolescence and it often involves an oozing, crusting rash mainly on the scalp and face, although it can occur anywhere on the body . The appearance of the rash tends to modify, becoming drier in childhood and then scaly or thickened in adolescence while the itching is persistent.


The patient with atopic dermatitis reacts easily to irritants, food, and environmental allergens and becomes very itchy, leading to:

  • Redness
  • Skin edema (swelling)
  • Itching and dryness
  • Crusting or cracking
  • Flaking
  • Blistering
  • Oozing or bleeding

It is sometimes also called as “the itch that rashes” because the itchiness precedes the rash or scratching the itchy skin may cause the rash.


The exact cause of eczema is unknown/idiopathic but it is caused due to various factors like:

Genetic: There is evidence suggesting that atopic dermatitis is genetically inherited. People of all races can get eczema.

Histamine intolerance: Subsets of people afflicted with atopic dermatitis are affected by exogenous sources of histamine i.e. histamine from outside the body due to which histamine causes itching and discomfort. Certain vegetables like tomatoes, spinach and eggplant naturally contain histamine.

Aggravating factors The following factors leading to worsening symptoms of atopic dermatitis:

  • Allergies to pollen, mold, dust mites or animals
  • Cold and dry air in the winter
  • Colds or flu
  • Contact irritants and chemicals
  • Contact with rough materials like wool
  • Dry skin
  • Emotional stress
  • Perfumes or dyes added to lotions or skin soaps
  • UV light radiation


Diagnosis of eczema is based mostly on

  1. History
  2. Symptoms
  3. Physical examination


Although there is no cure for atopic eczema, through medications one can ease the symptoms. Medication used to treat atopic eczema most commonly includes:

  • Emollients – used all the time for dry skin
  • Topical corticosteroids – used to reduce swelling and redness during flare-ups


Those with eczema should not get the smallpox vaccination due to risk of developing eczema vaccinatum, a potentially severe and sometimes fatal complication.