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How common is eczema?
Eczema is one of the most common skin disorders. Studies by general practitioners suggest that around 30 per cent of all people with skin problems have eczema. Of those referred to hospital with skin problems, about 20 per cent have eczema in some form. Atopic eczema is the most common form, particularly in children, affecting 10–20 per cent to some extent.

What kind of eczema is it?
The table on pages 8–9 outlines the main types of eczema and should help you identify which type you are dealing with. Eczema can also be categorised according to the main sites or the age groups typically affected. Each category is described in greater depth later in the book.


Is it definitely eczema?
Several skin conditions are red and itchy like eczema and may look the same initially; some are described here. It is, however, important to seek medical advice about any persistent or worrying rash.

Urticaria
Also known as hives, this is a distressing itchy rash of red bumps with a surrounding pale ring. Urticaria can crop up all over the body. It tends to move around, settling in one area then appearing elsewhere, usually over a period of about 24 hours. The rash can disappear completely for short periods; it may go away during the night and gradually reappear during the day. Unlike eczema, the skin does not become particularly dry and will not ooze unless scratching is so severe that it breaks the surface. Urticaria usually settles within a few days – although sometimes it can go on for months.
Urticaria, also known as hives, is an intensely itchy rash that may affect the whole body or just an area of skin. It is usually caused by an allergic reaction.
Psoriasis
Psoriasis can look like eczema at several sites on the body, but is far less common in childhood. The rash appears more silvery and is less itchy. Unlike eczema, it can have a very clear edge, which is some-times slightly raised. Psoriasis is more likely to affect the front of the knees and back of the elbows. It is more common in the scalp and around the ears, and there may be changes in the nails with small dents (pits) and lifting up of the nails. Psoriasis may be confused with seborrhoeic eczema or gravitational eczema.



The epidermis in psoriatic skin turns over much more rapidly than that in normal skin. Immature skin cells reach the surface, forming plaques of loose visible skin.

Rashes with fever
Blotchy red rashes are common during childhood. Some are connected with specific illnesses, such as German measles (rubella), or just with having a high fever. Sometimes, the rash has no obvious cause, and will pass within a day or two and cause no concern.

The important rash not to miss is the rash of meningococcal meningitis. All the other rashes mentioned so far are red, but look paler if examined through the bottom of a glass, pressed against the skin. In meningococcal meningitis, bleeding into the skin produces patches of purple discoloration which do not become pale when the glass is pressed against the skin. There is no blood on the surface, however, and no blood will come off on the glass. Also, the rash is not itchy. If you are worried that a rash may be the result of meningitis, seek urgent medical help.



If you are worried that a rash may be the result of meningitis, seek urgent medical help. In meningococcal meningitis bleeding into the skin produces patches of purple discoloration which do not become pale when the bottom of a glass is pressed against the skin.
 
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