The classification and definitions of diseases from the spectrum of eczema

The term "eczema" does not refer to a specific disease, but to a syndrome of characteristic clinical features that are common for a heterogeneous group of diseases with various etiology. The difficulty with differentiating various types of eczema is partly due to overlapping, sometimes even conflicting definitions. As the diagnosis is based mainly on clinical picture and history, diagnostic decisions are greatly influenced by beliefs of individual doctors. The aim of the present study was to discuss diverse types of eczema in the light of current knowledge, as well as propose a classification of eczema that could be useful for practical doctors. The proposed etiology-based classification comprises eczema types most relevant in the practice: eczema without identifiable exogenous triggers ("endogenous" atopic eczema), eczema caused by exogenous factors without involvement of specific hypersensitivity reactions (irritant contact dermatitis, microtrauma or friction dermatitis, phototoxic dermatitis and radiation dermatitis), eczema caused by exogenous factors with the involvement of specific hypersensitivity ("exogenous" atopic eczema, allergic contact dermatitis, photoallergic dermatitis, protein contact dermatitis), eczema due to autoimmune reactions (autoimmune eczema, autoimmune progesterone dermatitis), and finally, eczema due to impaired skin homeostasis (seborrhoeic dermatitis, asteatotic dermatitis, stasis dermatitis). Other, not included in this classification terms pertaining eczema are also discussed. In routine usage, sometimes it seems practical to use collective terms combining diseases with different etiology, yet sharing relevant clinical characteristics or legal status, such as nummular eczema, dishydrotic eczema, airborne dermatitis, hand eczema, foot eczema, consort/connubial dermatitis or occupational dermatitis.

Keywords: eczema, dermatitis, clinical entities, classification.

Related articles:

1. Spiewak R. Contact dermatitis in atopic individuals. Curr Opin Allergy Clin Immunol 2012; 12 (5): 491-497.

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Dermatologist and allergist in Krakow (Cracow), Poland

Estetologia Medyczna i Kosmetologia