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, D.M.D., M.D.

Overview

Several medical conditions can mimic eczema, with overlapping features. These conditions could be due to an inflammatory, infectious, immunodeficiency, or a nutritional deficiency problem. It is important to differentiate one from another to render proper medical treatment.

Differential Diagnosis

• Several medical conditions can mimic eczema, with overlapping features. These conditions could be due to an inflammation, neoplasm, immunodeficiency, or a nutritional deficiency problem.
• Table 1 summarizes these medical conditions, with their corresponding expected time of presentations.

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.