What is "eczema"?

Area of Science:

• Dermatology
• Immunology
• Pathophysiology

Background:

• Eczema is a prevalent inflammatory skin disorder frequently encountered in clinical practice.
• It is characterized by itch, multiple pinpoint lesions, and polymorphism, encompassing various skin manifestations.
• Understanding eczema's pathophysiology is crucial for managing this common condition.

Purpose of the Study:

• To detail the morphological and cellular characteristics of eczema.
• To explore the immunological underpinnings of acute and chronic eczema.
• To investigate the comorbidities associated with eczematous diseases.

Main Methods:

• Review of morphological features including erythema, papules, vesicles, and lichenification.
• Analysis of cellular processes like spongiosis, hyaluronic acid production, and immune cell infiltration (Th1/Tc1, Th2/Tc2, Th17, Th22, Tc22, innate lymphoid cells).
• Examination of molecular contributors to chronic eczema, such as periostin and melanogenesis.

Main Results:

• Acute eczema involves spongiosis, altered hyaluronic acid and E-cadherin levels, and specific immune cell infiltrates.
• Chronic eczema is marked by lichenification, hyperpigmentation (due to melanogenesis and pigment deposition), and dermal fibrosis.
• Eczematous diseases are linked to increased risks of allergic conditions, coronary heart disease, and mental health issues like depression.

Conclusions:

• Eczema exhibits diverse presentations in acute and chronic phases, driven by distinct cellular and molecular mechanisms.
• Immune cell involvement is critical in eczema pathogenesis.
• Eczema management requires a holistic approach, considering potential comorbidities.