Differential diagnosis of eczema
OPTIMISING MOISTURISER USE IN CHILDHOOD ECZEMA
Differential diagnosis of eczema
NICE suggests diagnosing eczema when a child has at least three of the following signs and symptoms in addition to itch:14
- Visible dermatitis involving skin creases (flexural dermatitis), such as the bends of the elbows or behind the knees. Children aged 18 months and younger with eczema may show dermatitis on their cheeks, extensor areas or both
- Personal history of flexural dermatitis. In children aged 18 months and younger a personal history of dermatitis on their cheeks, extensor areas or both
- Personal history of dry skin in the last 12 months
- Personal history of asthma or allergic rhinitis or, in children younger than 4 years of age, history of atopic disease in a first-degree relative
- Onset of signs and symptoms when the child was younger than 2 years of age. This criterion does not apply to children aged 2-4 years of age.
Click here to familiarise yourself with examples of other skin conditions that may present in the pharmacy.
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| Differential diagnosis | Features |
|---|---|
| Allergic contact dermatitis | An eczematous rash anywhere on the body exposed to a topical allergen; patients may be any age. Allergic contact dermatitis can trigger eczema |
| Fungal infection | Ring-shaped patch or plaque with slightly raised (possibly scaly) border and clearer middle |
| Psoriasis | Less itchy than eczema; well-defined, reddish, flat-topped plaques with silvery scales; usually symmetrical |
| Scabies and other infestations | Raised rash or spots accompanied with sudden onset of itching |
| Seborrhoeic dermatitis | Red, bordered lesions with greasy scales; usually restricted to areas where sebaceous glands are present, such as ears, eyebrows, scalp and around the sides of the mouth |