Eczema
Eczema (atopic dermatitis) is a chronic, relapsing inflammatory skin condition, managed per American Academy of Dermatology (AAD) guidelines of care.
Symptoms
Itching, redness, dryness, and sometimes weeping or crusting, classically in the creases of elbows and knees, though the pattern varies by age.
Causes and risk
A genetically weakened skin barrier combined with immune dysregulation; family history of eczema, asthma, or allergies (the "atopic triad") substantially raises risk.
How it is evaluated
Diagnosis is clinical, based on itching plus a characteristic pattern and course; it doesn't require lab testing to confirm.
Treatment
Moisturizers are foundational at every severity level. Topical corticosteroids are first-line for flares, with twice-weekly maintenance dosing to prevent recurrence; calcineurin inhibitors and crisaborole are steroid-sparing alternatives. For moderate-to-severe disease not controlled topically, dupilumab is generally the favored first-line biologic, per the AAD systemic therapy guideline, with other biologics and JAK inhibitors as further options.
When to seek care
Monomorphic, "punched-out" blisters with fever and malaise suggest eczema herpeticum -- a dermatologic emergency, occurring almost exclusively in people with atopic dermatitis, that requires prompt antiviral treatment, per current NEJM case guidance.