1. eczema

2. Definition
Pruritic papulovesicular dermatitis characterised by erythema, oedema and a serous exudate in the epidermis.

3. Pathogenesis Two hypotheses:
1) Immunological disturbance causes IgE-mediated sensitisation, epithelial barrier dysfunction is secondary (Endogenous Eczema)
2) Epidermal barrier dysfunction allows irritants and allergens into the skin, with immunological disturbance secondary (Exogenous Eczema)

4. classified by pathogenesis
Contact dermatitis
Housewives hand eczema
Keratodermia tylodes palamaris progressiva(Hand eczema)
Diaper dermatitis
Atopic dermatitis
Seborrheic dermatitis
Nummular eczema
Lichen simplex chronicus
Lichen Vidal autosensitisation dermatitis
Stasis dermatitis

5. Staging of eczema
Acute eczema
Subacute eczema
Chronic eczema

6. 1- Acute eczema
It is accompanied by exocytosis of lymphocytes and spongiotic bulla.

7. clinical feature
Exudative erythema
Oedema
Vesicles (sometimes)
Intercellular oedema (spongiosis), intense dermal oedema, and inflammation occur.
Acanthosis usually does not

8. Skin care: moisturizing the skin AND avoid irritant.
treatment
Education!
Skin care: moisturizing the skin AND avoid irritant.
Topical corticosteroids.

9. 2- Subacute eczema
Subacute eczema has a severity between that of acute and that of chronic

10. clinical feature
Erythema
Oedema, and it is slightly lichenoid.
Mild oedema is produced in the epidermis.
Acanthosis
Parakeratosis are observed

11. 3- Chronic eczema
Hyperkeratosis
Parakeratosis
Irregular acanthosis, and elongation of rete ridges are observed.
Spongiosis and spongiotic bulla are less severe in chronic eczema than in acute eczema more than one week after onset

12. clinical feature Lichenification Dry, sensitive skin
Red, inflamed skin
Scaly areas 
Recurring rash
Rough, leathery patches
Swelling
Dark-colored patches of skin

13. treatment
Choose the correct steroid for the site and activity of disease.
Remove the causative agents if it is contact dermatitis.
Treat the dryness (Emollients).
Use keratolytics if it is seborrhoeic eczema.
Antihistamines (Itching).