Eczema differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Edzel Lorraine Co, DMD, MD[2]

Overview

Eczema has various mimics with regards to the clinical presentation, severity, and course of disease. A strong clinical evaluation by the physician based on the presenting signs and symptoms is needed to come up with the correct diagnosis. Differential diagnoses of eczema include infectious disease, inflammatory disease, immunodeficiency problem, or a nutritional deficiency.

Differential Diagnosis

A strong clinical evaluation by the physician based on the presenting signs and symptoms is needed to come up with the correct diagnosis.

• Table 1 summarizes these medical conditions that can mimic the presentation of eczema, with their corresponding expected time of onset.

Table 1. Differential Diagnosis of Eczema.

Type	Medical Condition	Manifestations	Expected Time of Presentation
Inflammatory	Psoriasis	Plaque with silvery scales.	Adolescence to adulthood.
	Viral Exanthem	Morbiliform rash	Infancy.
	Contact Dermatitis	Vesicular and pruritic.	Infancy.
Neoplastic	Cutaneous T-cell Lymphoma	Eczematous patch. Resistant to topical steroids.	Adulthood.
Immunodeficiency	Wiskott-Aldrich Syndrome	Recurrent infections, failure to thrive, and resistant to topical steroids.	Infancy.
	Netherton syndrome	Recurrent infections, failure to thrive, and resistant to topical steroids.	Infancy.
	Hyper IgE syndrome	Recurrent infections, failure to thrive, and resistant to topical steroids.	Infancy.
	DOCK8	Recurrent infections, failure to thrive, and resistant to topical steroids.	Infancy.
Nutritional Deficiency	Zinc	Weight loss.	Infancy to early childhood.
	Biotin	Failure to thrive.	Infancy to early childhood.