Eczema manifests distinct symptoms upon onset, typically diagnosed based on these characteristics: polymorphic rashes, symmetrical distribution, indistinct borders, tendency to ooze, intense itching, recurrent flare-ups, and chronic progression. Diagnosis is generally straightforward.However, acute eczema must be differentiated from contact dermatitis, chronic eczema from neurodermatitis, and hand-foot eczema from tinea manuum/pedis. Nummular eczema presents as well-defined patches ranging from coin-sized to palm-sized or larger, also known as discoid eczema. It features erythema,vesicles, or papulovesicles forming plaques, or crusting and scaling, presenting as localized subacute eczema. It causes intense itching, typically occurring on the backs of hands and fingers, though it may also appear on the extensor surfaces of limbs, the tops of feet, shoulders, or buttocks. It often fluctuates in severity, with frequent relapses, particularly during colder seasons.
Several conditions may present with symptoms similar to eczema, necessitating careful differential diagnosis. Eczema is a common dermatological disorder; when encountering itchy lesions with exudate, erythema, papules, or vesicles, eczema should be considered.Conditions challenging to differentiate from eczema include infectious eczema-like dermatitis, primary irritant or allergic contact dermatitis, and atopic dermatitis. Eczema must also be distinguished from candidiasis, seborrheic dermatitis, prurigo, pityriasis rosea, and polymorphic light eruption.