Eczema is a multifactorial skin issue that presents in many different forms. For appropriate management, it's crucial to identify the specific type of eczema one is dealing with. A description of each type can be found in this article.
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The various forms of eczema.
What exactly is eczema?
Eczema is a chronic skin disease . It is characterized by dry skin accompanied by red lesions. These are raised and rough, causing significant itching . With persistent scratching, they crack, peel, and ooze. Eczema can also form crusts or thicken.
This dermatological disorder affects many people, but particularly targets infants and children. It's worth noting that 30% of consultations related to a skin disease concern eczema, placing this dermatosis in second place, just behind theacne. There are many misconceptions circulating about eczema, but it's important to know that it is a non-contagious disorder and benign, despite the many repercussions it can have on the lives of those affected.
What are the main forms of eczema?
There are numerous forms of eczema, each with different causes. They are generally classified based on their origin and the area of the body they affect. Here are the two most common types of eczema:
Atopic eczema.
origin genetic .
Studies have indeed shown that this form of eczema is often associated with mutations on the genes coding for filaggrin and other proteins essential to the integrity of the stratum corneum. This results in an ineffective skin barrier that easily allows water to evaporate and allergens to penetrate. Moreover, individuals with atopic dermatitis typically secrete large amounts of immunoglobulin E (IgE) in response to environmental antigens, causing disproportionate immune reactions when the skin comes into contact with a common allergen (animal hair, dust...).
Being linked to a genetic predisposition, it is unfortunately impossible to completely eliminate atopic eczema. However, the daily application of an emollient and the use of dermocorticoids during flare-ups can significantly reduce its symptoms and thus improve the quality of life for those who suffer from it.
Thecontact eczema.
Also referred to as contact dermatitis, contact eczema is a result of exposure to a specific allergen and is not linked to genetics. The skin's reaction occurs after contact with an allergenic substance. Four major sources of allergens, present in our everyday environment, are generally the cause of contact eczema. These include clothing items, cosmetics, topical medications, and occupational allergens, meaning those present at work (cement, paint, pesticides, gloves...). The symptoms of contact eczema are similar to those of atopic eczema. However, unlike atopic dermatitis, it is possible to completely eliminate contact eczema by avoiding contact with the responsible allergen.
Are there other forms of eczema?
While atopic eczema and contact eczema are the most common forms of eczema, there are other types as well. Here is a brief description of each of them:
Nummular eczema.
Nummular eczema, also known as discoid eczema, is a form of eczema characterized by red, round patches on the skin, accompanied by itching. The lesions of nummular eczema have a well-defined appearance, similar to a coin, hence its name. This skin condition can affect different parts of the body, but it is generally localized on the arms, legs, and buttocks. Nummular eczema is often a specific form of atopic dermatitis. In non-atopic individuals, meaning those whose skin barrier does not have any dysfunction, the etiology of nummular dermatitis is unknown.
Thevaricose eczema.
Varicose eczema is caused by venous insufficiency. It particularly affects individuals with a history of phlebitis or varicose veins and is localized on the legs or around the ankles. Varicose eczema is characterized by red, oozing patches accompanied by intense itching. This form of eczema requires prompt treatment to prevent it from progressing into a varicose ulcer. The latter never fully heals and develops into a chronic wound.
This form of eczema is characterized by vesicular lesions on the palmoplantar epidermis, either on the edges of the fingers or toes or on the palms of the hands or soles of the feet. These vesicles are filled with a clear fluid and are accompanied by itching. The exact cause of dyshidrotic eczema is still unknown to this day. However, it appears that individuals prone to other forms of eczema such as atopic eczema or contact eczema are more affected.
Dietary deficiency eczema.
Recent studies have shown that eczematous lesions can sometimes be correlated with a zinc deficiency. This is then referred to as deficiency eczema, a specific form of atopic eczema or contact eczema. Indeed, zinc is a trace element that plays a crucial role in immune balance. Zinc supplementation in individuals with a deficiency and suffering from atopic eczema led to an improvement in their symptoms after 8 weeks of treatment.
Sources
GOLDENBERG G. & al. Eczema. The Mount Sinai journal of medicine (2011).
RO Y.S. & al. Hair zinc levels and the efficacy of oral zinc supplementation in patients with atopic dermatitis. Acta Dermato-venereologica (2014).
SAURAT J. H., LACHAPELLE J. M., LIPSKER D., THOMAS L. et BORRADORI L. Dermatologie et infections sexuellement transmissibles. Elsevier Masson (2017).
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