Eczema – Other forms
The other main types of eczema are seborrhoeic, discoid, venous, asteatotic and hand dermatitis.
Seborrhoeic dermatitis
Seborrhoeic dermatitis is a chronic, red, scaly, inflammatory eruption usually affecting the scalp and face (Table 1).
Table 1 Differential diagnosis of seborrhoeic dermatitis
| Site of seborrhoeic dermatitis | Differential diagnosis |
|---|---|
| Face | Psoriasis, contact dermatitis, rosacea |
| Scalp | Psoriasis, fungal infection |
| Trunk | Psoriasis, pityriasis versicolor, fungal infection |
Clinical presentation
There are four common patterns:
1. Scalp and facial involvement. Excessive dandruff, with an itchy scaly erythematous eruption affecting the sides of the nose, scalp margin, eyebrows and ears (Fig. 1). Blepharitis may occur. Most common in young adult males.
2. Petaloid. A dry, scaly patch of eczema over the presternal area.
3. Pityrosporum folliculitis. An erythematous follicular eruption with papules or pustules over the back (Fig. 2).
4. Flexural. Involvement of the axillae, groin and submammary areas by a moist intertrigo, often secondarily colonized by Candida albicans. Seen in the elderly (do not confuse with the similarly named infantile eruption, p. 116).
Discoid (nummular) eczema
Discoid eczema is an eczema of unknown aetiology characterized by coin-shaped lesions on the limbs; it typically affects middle-aged or elderly men (Fig. 3). Younger subjects, especially in dark skin types, may have atopic eczema.
