According to Habif’s clinical dermatology, 5th edition, “Eczema (Eczematous inflammation) is the most common inflammatory skin disease. Although the term dermatitis is often used to refer to an eczematous eruption, the word means inflammation of the skin and is not synonymous with eczematous processes. Recognizing a rash as eczematous rather than psoriasiform or lichenoid, for example, is of fundamental importance if one is to effectively diagnose skin disease.” Habif discusses the 3 stages of eczema: Acute, subacute, and chronic with different treatment approaches. each of the phases, he says, represents a stage in the evolution of a dynamic inflammatory process. Worth noting is that an “eczematous disease can start at any stage an evolved into another.”
The 3 Stages of Eczematous Inflammation
Acute stage has vesicles, blisters, and intense redness. There is intense itching. An example of an acute stage eczematous rash is the contact allergy (poison ivy) rash. Other etiologies according to Habif, are, severe irritation, id reaction, acute nummular eczema, stasis dermatitis, pompholyx (dyshidrosis), and fungal infections.” You treat with “cold, wet compresses; oral or IM steroids; topical steroids; antihistamines, and antibiotics” as needed.
The subacute stage has “redness, scaling, fissuring, parched appearance or, scalded appearance.” There is a “slight to moderate itch, pain, stinging, and burning.” Examples of etiologies and clinical presentation, according to Habif, are “contact allergy, irritation, atopic dermatitis, stasis dermatitis, nummular eczema, asteatotic eczema, fingertip eczema, and fungal infections.” You treat with topical steroids with or without occlusion, lubrication, antihistamines, antibiotics as needed, tar.
The chronic stage has “thickened skin, lichenified skin (accentuated skin lines), excoriations, fissuring.” There is moderate to intense itch. Common etiologies and presentation are “atopic dermatitis, habitual scratching, lichen simplex chronicus, chapped fissured feet, nummular eczema, asteatotic eczema, fingertip eczema, hyperkeratotic eczema.” “Topical steroids (with occlusion for best results), intralesional steroids, antihistamines, antibiotics, lubrication.”
Diseases that present as subacute eczematous inflammation
Habif lists the following diseases that present with subacute eczematous inflammation.
- Allergic contact dermatitis
- Atopic dermatitis
- Asteatotic eczema
- Chapped fissured feet (sweaty sock dermatitis)
- Circumileostomy eczema
- Diaper dermatitis
- Exposure to chemicals
- Intertrigo
- Irritant contact dermatitis
- Irritant hand eczema
- Nipple eczema (nursing mothers)
- Nummular eczema
- Perioral lick eczema
- Stasis dermatitis
In his chapter on atopic dermatitis, chapter 5, Habif says, “atopic dermatitis (AD) is a chronic, pruritic eczematous disease that nearly always begins in childhood and follows are remitting/flaring course that may continue throughout life.”
So, atopic dermatitis, which is commonly referred to as eczema, is a type of eczema (eczematous inflammation).
From the above, I think (need to check) that eczema (eczematous inflammation) is a specific type of skin inflammation with specific properties and stages that have different properties. The term dermatitis (though it covers eczema) is a general term for inflammation of the skin. Eczematous inflammation is an inflammation of the skin, but not all inflammation of the skin is eczematous.
If it were put in a Venn diagram, inflammation would be the largest of two circles. Within it would be the eczematous inflammation circle, and within the eczematous inflammation circle would be atopic dermatitis, which is a type of eczematous inflammation.
The uptodate.com article below says:
“The terms “dermatitis” and “eczema” are frequently used interchangeably. When the term “eczema” is used alone, it usually refers to atopic dermatitis (atopic eczema). “Eczematous” also connotes some scaling, crusting, or serous oozing as opposed to mere erythema. The term “dermatitis” is typically used with qualifiers (eg, “contact dermatitis”) to describe several different skin disorders.”
The AAD website lists different types of “Eczema/Dermatitis” as:
- Atopic dermatitis
- Contact dermatitis
- Dyshidrotic eczema
- Neurodermatitis
- Nummular dermatitis
- Stasis dermatitis
The National Eczema Association lists different types of eczema as follows:
- Atopic dermatitis
- Contact dermatitis
- Dyshidrotic eczema
- Nummular eczema
- Seborrheic dermatitis
- Stasis dermatitis
Further Reading
https://www.uptodate.com/contents/overview-of-dermatitis-eczema