DefinitionDefinition EtiologyEtiology PathogenesisPathogenesis Clinical characterClinical character Diagnosis and differential Diagnosis and differential

diagnosisdiagnosis TherapyTherapy

DefinitionDefinition

Caused by various internal or exterCaused by various internal or external factors, related to allergic reactionnal factors, related to allergic reaction. Clinical characters include multiform. Clinical characters include multiformity of original lesions ,easy to exudatioity of original lesions ,easy to exudation,severe itch,recurrence and tending tn,severe itch,recurrence and tending to chronic lesions.o chronic lesions.

..

Eczema usually results from a Eczema usually results from a hypersensitivity or allergy that hypersensitivity or allergy that causes inflammation. The causes inflammation. The inflammation causes the skin to inflammation causes the skin to become red, itchy, and scaly. become red, itchy, and scaly. 

etiologyetiologyinternalinternal

Atopic Genetic

facter

eczema （ or aggravation ）

externalexternal

Psychological facter （ tired 、 tension ）

Endocrine turbulence （ aggravation when menses ）

Metabolize disorder

ingested allergen （ fish 、 shrimp ）

inhale pollen 、 dust 、 scurf

Physical and chemical factor （ soap 、scour 、 wet and hot ）

etiopathogenesisetiopathogenesisⅣⅣ 、Ⅱ 、Ⅱ type allergic reaction and ADCC type allergic reaction and ADCC Atopic dermatitisAtopic dermatitis ：： antibody aimed to antibody aimed to

keratinocyte in the superficial layer of pkeratinocyte in the superficial layer of prickle stratum rickle stratum （ Ⅱ （ Ⅱ type type ），）， completcompletment participatement participate ，， ADCC also relatedADCC also related

Manifestation of eczema similar to patcManifestation of eczema similar to patch test reacth test react （ Ⅳ （ Ⅳ type type ））

Tissue immunopathogenesis find lots oTissue immunopathogenesis find lots of LC and Tf LC and Thhcell in the localcell in the local

clinicl featureclinicl feature （一）（一） Acute eczemaAcute eczema

predilection site predilection site ：： headhead 、、 faceface 、、 limbs or trulimbs or trunknk

symmerysymmery polymorphouspolymorphous ：： erythemaerythema 、、 papulepapule 、、 papulovespapuloves

icleicle 、、 phlysisphlysis exudativeexudative ：： more oozing erosionmore oozing erosion 、、 incrustationincrustation Pruritic: irritation of scratchingPruritic: irritation of scratching 、、 hot waterhot water 、、 soasoa

p secondary infectionp secondary infection recurrentrecurrent ，， tend to develop into subacute or chrotend to develop into subacute or chro

nic eczemanic eczema

（二）（二） subacute subacute red swellingred swelling 、、 exudation lessenexudation lessen ，， some psome p

apuleapule 、、 papulovesiclepapulovesicle 、 、 with erosionwith erosion 、、 ii

ncrustationncrustation

Acute attack of chronic eczemaAcute attack of chronic eczema

lesionslesions ：： thickening and invasive patchingthickening and invasive patching

，， lichenification, small papule scattered aroundlichenification, small papule scattered aroundintensive pruritus : striationintensive pruritus : striation 、、 erosionerosion 、、 bb

lood scarlood scarcoursecourse ：： chronic or heal chronic or heal 、 、 recurrecurpredilectionpredilection ：： hand eczemahand eczema

nipple eczemanipple eczema scrotum eczemascrotum eczema leg eczema, more often see hleg eczema, more often see h

ypostatic eczemaypostatic eczema

（三） chronic eczema

Diagnosis and differential Diagnosis and differential diagnosis diagnosis

1. Polymorphous and primary lesions1. Polymorphous and primary lesions 2. exudative2. exudative 3. symmery3. symmery 4. pruritic4. pruritic 5. recurrent5. recurrent ，， easy to diagnosiseasy to diagnosisTo distinguish with contact dermatitis aTo distinguish with contact dermatitis a

nd neurodermatitisnd neurodermatitis

TherapyTherapy （一）（一） avoid incentiveavoid incentive ，， such as scratchsuch as scratch 、、 burnburn 、、 soap swabbingsoap swabbing 、、

acor acor 、、 alcohol abuse et alalcohol abuse et al（二）（二） systemic therapysystemic therapy ：：

1.antihistamine1.antihistamine2.cortisone2.cortisone ，， dehydrocortisone20~40mg/ddehydrocortisone20~40mg/d suitable for acutesuitable for acute 、、 general lesion and severe patients ,they havgeneral lesion and severe patients ,they have no react to the general treatments.e no react to the general treatments.3. traditional chinese medicine(TCM)3. traditional chinese medicine(TCM) ：： using therapeutical princiusing therapeutical principle of clear heat and dehumidityple of clear heat and dehumidity 、、 cool the blood and eliminatiocool the blood and elimination wind n wind chushi needle 4ml intramuscular qd×10chushi needle 4ml intramuscular qd×10 redmannia drede rhizome injection ivredmannia drede rhizome injection iv

lishi mixture 10ml tidlishi mixture 10ml tid

（三（三 )topical treatment)topical treatment ：： exudationexudation ：： hydropathic compress with hydropathic compress with solution solution no exudedno exuded ：： lotionlotion 、、 powderpowder subacute compress or pastasubacute compress or pasta litte exudedlitte exuded ：： cream or pastacream or pasta thickening lesionthickening lesion ：： ointmentointment 、、 tinctinc

（四） radiation therapy ：

chronic and local eczema ： when other treatment ineffective

superficial layer x ray or isotope90Sr radiation 。

acute

chronic