The challenge with eczema lies in its complex causes, often resulting from the interaction of multiple internal and external factors. With numerous triggers and aggravating factors, it can be difficult to prevent. Additionally, the intense itching often leads patients to unconsciously scratch, scrub with hot soapy water, or experience mental distress, all of which worsen the condition and hinder healing. Furthermore, eczema is characterized by a long course and a tendency to recur, causing significant distress.
The primary internal factor is the patient's allergic constitution, which is genetically linked and can change with age and environment. Psychological factors (such as anxiety, tension, emotional distress, insomnia, and fatigue), endocrine imbalances, metabolic disorders, gastrointestinal dysfunction, and underlying infections also contribute to its onset.External factors like sunlight, cold, humidity, dryness, scratching, friction, cosmetics, soap, animal fur, dyes, synthetic fibers, and certain foods (seafood, eggs, etc.) may trigger or worsen eczema.
Based on progression, eczema is generally classified into acute, subacute, and chronic stages. These stages may transition between each other or manifest as a single stage.
Acute eczema typically develops rapidly, presenting diverse rash patterns. It initially manifests as edematous erythema, followed by dense clusters of miliary papules, papulovesicles, and vesicles. After vesicle rupture, erosions, exudation, and crusting occur. Central lesions coalesce into patches, surrounded by scattered small papules with indistinct borders, often exhibiting satellite-like distribution.Lesions often exhibit bilateral symmetry, commonly affecting the head, face, extremities, and perineum.
Subacute eczema may evolve from the acute phase, characterized primarily by small papules, scaling, and crusting, with only a few papulovesicles, small vesicles, and erosions. Itching is typically more intense.
Chronic eczema often develops from recurrent episodes of acute or subacute eczema, presenting with rough, thickened skin, partial lichenification, and possible scratch marks, crusting, and hyperpigmentation.Rashes are often localized, commonly appearing on hands, feet, lower legs, elbow creases, popliteal fossae, vulva, and anus, with symmetrical distribution. Itching is intense and paroxysmal, worsening with heat or at night. The course is variable, prone to recurrence, and often persistent.
Preventing eczema primarily involves thoroughly reviewing medical history, conducting necessary examinations, identifying potential causes or triggers to eliminate or avoid them, understanding the patterns of eczema onset and progression along with prevention methods, cooperating with treatment, maintaining skin cleanliness, avoiding external irritants like scratching, scalding water, or harsh soap scrubbing, and steering clear of pungent, spicy, or alcoholic foods.