Eczema historical perspective

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

Overview

• It was in the 20th century when eczema came into existence, and later on, concepts on this had evolved including major insights on the nature of the disease.

Historical Perspectives

• Over the years, dermatological conditions have become manifested in individuals.
• The evolution of concepts from the standpoint of historical perspectives was observed, wherein significant insights as to the nature of the disease were derived.

• Listed below is a summary of the evolution of eczema through the ages.

Table 1. History of Eczema Through the Ages.

Period	Highlights	Treatment
Ancient History	Ebers Papyrus (1500 BCE) This is the earliest medical document about dermatology that was compiled in Egypt.	Wind-heat or damp-heat were used to treat eczema Nai hsien, tai lien chung, and Hsin-san-miao-san are herbal remedies for infantile eczema that was known to have anti-inflammatory and moisturizing effects.
	Hippocrates (400 BCE) He explained the importance of skin manifestations in the identification of internal humoral medical conditions.
	Celsus (AD) He is a Roman physician who described the existence of a dermatological condition as a: " certain degree of hardness of the skin with pustules, some humid and some dry "
	Suetonius (AD) atopic syndrome found in Emperor Augustus was described in The Twelve Caesars
	Avicenna (980-1037 CE) He described the association of skin dryness and bathing
Premodern Era	Girolamo Mercurialis (1572) He is an Italian physician who wrote the very first dermatological text De morbis cutaneis which pertained to an oozing and pruritic condition on infant's head.
	Daniel Turner Pustular lesions or scabs on forehead, brows, and face were accounted by him. In one of his writings, he described how physicians were reluctant to provide medications for itching or eczema as they believed that this would make the condition worse.
	Jean-Louis Alibert (1806) He is a French dermatologist who had noted the occurrence of an oozing, pruritic dermatological lesion in infants which he termed "teigne muqueuse", or also translates to "mucosal ringworm".
	Willan and Bateman (early 19th century) They are English physicians who devised a classification scheme for dermatological conditions according to the type of primary lesion (papule, pustule, or vesicles). They coined the name "eczema" derived from the Greek word 'ekzein which means to erupt or to boil over.	Restoration of equilibrium.
	Pierre Rayer (1835) He introduced the concept of chronicity of eczema.
	Ferdinand von Hebra (1860) He is a Viennese dermatologist who came up with a novel disorder which was known as "Hebra's prurigo". This was described as itchy papules found on the limbs and trunk. Characteristics include symmetric lymphadenopathy, excoriations, and thickened, darkened and roughened skin.	He used topical remedies which include soap, lotions, oils, tars, and ointments.
	Erasmus Wilson He was credited with the discovery of infantile eczema, which was similar to the concept by Wilan and Bateman. The lesion was said to be pruritic at night time.	He advocated for systemic management, through the use of arsenic and more emphasis on diet.
	Ernest Besnier (1892) He was a French physician and medical director of Hospital Saint Louis. He introduced the current perception on atopic dermatitis.
Twentieth Century and Beyond	Von Pirquet (1906) He described the concept of allergy, which meant an abnormal reaction of the body to any substance.
	Coca and Cooke (1923) They proposed the concept of atopy.
	Wise and Sulzberger (1933) They used the concept by Coca and Cooke,and was able to conceptualize the atopic dermatitis.	They reported the effectiveness of hydrocortisone for management of erythema, pruritus and scaling.
	Blackfan and Talbot (1916) They discovered the importance of testing for presence of food proteins, and restrict them, if possible, to prevent hypersensitivity reactions.
	Hanifin and Rajka (1980) They were known for making the widely used diagnostic criteria for atopic dermatitis.