Differential Diagnosis > Morphology > Reaction Patterns > Eczematous

Eczematous

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A reaction pattern that exists “in between” the vesico-bullous and papulosquamous reaction pattern

acute = vesicles
subacute = papulosquamous
chronic = lichenified

 

"Eczema" and "dermatitis" are synonyms. They are broad terms and the only meaning they imply is that the histology is "spongiotic", therefore it is always better to give a diagnosis of a specific type of eczema.  Use the following mnemonic to try to assign a specific diagnosis.

 

CANDID SCALES (mnemonic)

Contact dermatitis
Atopic dermatitis
Nummular eczema
Dishydrotic eczema
Id reaction
Drug (usually not eczematous, but possible)

 

 

Seborrheic dermatitis
CTCL
Asteatotic eczema
Lichen simplex chronicus
Eczematoid (infectious;  e.g. pus dripping from the ear causing an eczematous reaction)
Stasis dermatitis

 

extended ddx:  actinic prurigo (photo-distributed),  autoimmune progesterone dermatitis