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Eczema

The term eczema is derived from a Greek word that means "to boil out or over."  It is a convenient "wastebasket" for many undiagnosed rashes but is best applied to eruptions that are characterized histologically by intercellular edema (water filled), called spongiosis.  Eczema and dermatitis are synonyms.  Acute dermatitis has a marked amount of edema causing blisters.  Subacute dermatitis has less spongiosis, resulting in "juicy papules."  Chronic dermatitis has a markedly thickened epidermis (lichenification) with only slight spongiosis.

The hallmarks of dermatitis are marked itching, indistinct borders (except for contact dermatitis), and epidermal changes characterized by blisters, juicy papules, or lichenification.  Dermatitis may be localized or diffuse; it may be idiopathic or may have a specific cause.  Contact allergy is the best-understood cause of an eczematous reaction and potentially is the most correctable.  For any eczematous rash, the first question to be asked is, "Could it be contact dermatitis ?"

- Lookingbill DP, Marks JG: Eczematous Rashes. Chapter in Principles of Dermatology, Chapter 9, W.B. Saunders Company Philadelphia, pp 131-149, 2000.