Page:Skin Diseases of Children.djvu/67



Eczema is at all ages the most important skin disease which the physician is called upon to treat. In infancy and childhood it is especially common, and usually a source of great discomfort to the patient. A full discussion of the subject would require much time and space, and in the few pages allotted to it here only a few points Can be briefly mentioned and a few practical suggestions offered.

Eczema is an inflammation of the skin, of which the symp- toms are commonly redness, thickening, moisture, crusting, and itching. The disease may present a great variety of appearances, according to the locality involved and the duration and severity of the inflammation. It may bear a resemblance to nearly every other skin affection, but in most cases, especially in childhood, the disease is readily recognized. Unlike many other cutaneous affections, it has no characteristic lesion, but may be erythematous, papular, vesicular, or pustular at the outset and gradually become crusted, scaly, fissured, or ulcerated. As regards the grade of inflammation, the disease may be observed in an acute, subacute, or chronic form, and as regards duration it may in one case be insignificant and ephemeral while in another case it may persist or recur year after year.

A multitude of adjectives have been applied to the numerous and varied clinical forms of eczema, and are useful for purposes of description, but the main thing for the physician to learn is to recognize the eczematous nature of the eruption, and to remember that different clinical forms may coexist upon different portions of the body and that one form is very likely to develop into another as the eruption becomes better or worse.

Eczema in childhood, as in later years, may occur in either an acute or chronic form. These terms, as commonly used, indicate the grade of inflammation rather than the length of time which the eruption has existed. In the acute form there is much redness, heat, and swelling, while in the chronic form