Eczema is a common allergic inflammatory skin disease characterized by diverse rashes, symmetrical distribution, intense cutaneous pruritus, recurrent episodes, and a tendency to become chronic. It can occur at any age, in any location, and during any season, but often recurs or worsens in winter.

bubble_chart Etiology

The onset of eczema is currently widely believed to be a delayed hypersensitivity reaction triggered by complex internal and external factors. Eczema patients often have an allergic constitution, which is related to genetic factors, hence the occurrence in specific populations.

Common internal factors include gastrointestinal dysfunction, neurological disorders, endocrine imbalances, internal infection foci, and intestinal parasites such as Chinese Taxillus Herb.

External factors such as sun exposure, wind, cold, scratching, and contact with soap or cosmetics can also induce eczema. Consuming spicy or irritating foods may exacerbate eczema in some individuals.

bubble_chart Diagnosis

1. According to the course of the disease, it can be divided into three types: acute, subacute, and chronic:
   1. Acute eczema: The onset is sudden, often symmetrically distributed, and commonly affects the head, face, limbs, and external genitalia. During the progression of the disease, various types of rashes such as erythema, papules, vesicles, pustules, erosions, and crusts may appear sequentially, but often two or three types coexist or one type predominates at a certain stage. Intense cutaneous pruritus frequently leads to scratching, exacerbating the condition.
   2. Subacute eczema: After the inflammation and symptoms of acute eczema subside, the rashes mainly consist of papules, scales, and crusts, but erosions may still occur after scratching.
   3. Chronic eczema: Often evolves from repeated episodes of acute or subacute eczema, but can also present as chronic inflammation from the outset. The affected skin becomes infiltrated and thickened, turning dark red with pigmentation. If persistent, the skin lesions may develop coarse texture, appearing dry and prone to rhagades. Commonly seen on the lower legs, hands, feet, elbow creases, external genitalia, anus, etc.
2. Based on location, it can be classified into the following types:
   1. Breast eczema: Mostly seen in lactating women, with moist, eroded, and crusted areolas. Over time, the skin may thicken and develop rhagades, causing pain during breastfeeding. If left untreated for a long time, hard nodules beneath the skin may indicate possible concurrent eczematoid carcinoma. Therefore, breast eczema should be monitored closely and examined promptly.
   2. Scrotal eczema: Acute cases present with swelling, exudation, and crusting. Chronic cases involve thickening and lichenification, with intense itching and a tendency to recur. Often associated with local profuse sweating, external genital irritation, neuroendocrine disorders, chronic prostatitis, etc.
   3. Vulval eczema: Commonly manifests as redness, swelling, erosion, and chronic thickening of the labia majora and minora and surrounding skin, accompanied by severe itching. Often related to fungal vaginitis, increased leucorrhea, and endocrine disturbances.
   4. Anal eczema: During the acute phase, there is redness, swelling, and erosion around the anus; the chronic phase involves infiltration, thickening, and even rhagades. Intense itching and pain, especially after bowel movements, are common. Frequent scratching may lead to thickened or thinned skin, atrophy, and a shiny appearance. In children, anal eczema is often linked to pinworms, while in adults, it is associated with hemorrhoids and profuse sweating.
   5. Hand eczema: When occurring on the palms, it tends to cause infiltration, thickening, and hyperkeratosis, leading to rhagades. Eczema on the fingertips often involves recurrent vesicles, crusting, thickening, and desquamation. If the nail bed is affected, it may impair nail development, resulting in rough, pitted nails. Contact with water, soap, or detergent often worsens the condition.
   6. Leg eczema: Predominantly affects the anterior tibial area and ankles, often caused by varicose veins or trauma. Symptoms include crusting, thickening, lichenification, as well as erosion and exudation, with a tendency for secondary infection or ulcer formation, making it stubborn and difficult to treat.

bubble_chart Treatment Measures

1. Household Medications
   1. Vitamin C 0.2 grams, taken orally three times daily. Vitamin B6 10–20 mg each time, taken orally three times daily.
   2. Common antihistamines include Chlorphenamine 0.3 mg or Cyproheptadine 2 mg, taken orally twice daily. Alternatively, Astemizole 10 mg can be taken once daily.
   3. For acute-stage widespread rashes, use 10% Calcium Gluconate 10 ml, administered intravenously once daily. Or Prednisone 10 mg, taken orally three times daily, with the dosage gradually reduced and discontinued after symptoms improve.
   4. If secondary infection occurs, administer Erythromycin 0.3 grams, taken orally three times daily.
   5. During the acute stage, apply 3% Boric Acid solution as a wet compress for 15–20 minutes each time, 3–4 times daily. After exudation decreases, apply Zinc Oxide Oil or Boric Acid Zinc Paste externally. If infection occurs, use 0.1% Rivanol solution as a wet compress and apply Erythromycin ointment externally.
   6. For the subacute stage, commonly use Boric Zinc Paste or 2–5% Black Soybean Tar Ointment. Alternatively, apply Fluocinolone Acetonide Dimethyl Sulfoxide Solution externally or use Fucining Plaster for topical application.
2. Chinese Medicinals and Folk Remedies
   1. Sophora and Alum, 15 grams each, and Phelloendron Bark 9 grams, boiled in 500–1000 ml of water. Wash the affected area with the warm decoction 3–4 times daily. Suitable for acute eczema.
   2. Shrubalthea Bark, Purslane Herb, and Dictamnus Root Bark in appropriate amounts, decocted and used to wash the affected area 2–3 times daily. Suitable for eczema with cutaneous pruritus.
   3. Dried Alum and Prepared Gypsum, 20 grams each, Realgar 7 grams, and Borneol 1 gram, ground into powder and mixed with 200 grams of Vaseline. Apply externally for chronic eczema.
3. Nutrition and Diet: Maintain a light diet, consume plenty of fruits, vegetables, legumes, and high-fiber foods. Avoid allergenic and irritating foods such as fish, shrimp, hot peppers, strong tea, coffee beans, and alcohol.
4. Precautions
   1. Trim nails short to avoid scratching or scalding, which may worsen the rash. As cutaneous pruritus intensifies in the evening, take Diphenhydramine 25–30 mg half an hour before bedtime.
   2. When applying or changing medication, avoid rinsing the skin with water, especially hot water, soap, or disinfectant solutions. Use a cotton swab dipped in vegetable oil to clean the area from the inside out.
   3. Antihistamines may cause side effects such as dizziness and drowsiness. Exercise caution after taking medication, especially for drivers and those working at heights. Jinfu antihistamines.
   4. Avoid highly irritating medications during the acute stage to prevent worsening the condition.

bubble_chart Prevention

1. Individuals with an allergic constitution or a family history of allergies should avoid various external irritants, such as hot water washing, scratching, sun exposure, etc., and try to avoid foods that are prone to cause allergies or irritation.
2. Maintain a regular lifestyle and pay attention to balancing work and rest.
3. Clothing should be loose to reduce friction and irritation, and avoid direct contact of synthetic fibers and woolen fabrics with the skin.