[Remarks and recommendations on the definition and classification of eczematous diseases]. 1986

O P Hornstein

Numerous nomenclatures and classifications of eczemas have puzzled dermatologists for a long time. This confusion is due to the great number of external as well as internal noxious factors and/or agents causing eczemas being themselves a distinct and histologically well defined reaction of the papillary-epidermal compartment. Current classifications do not adequately reflect the complex causative conditions involved in the etiopathogenesis of eczematous disorders. I propose, therefore, to classify eczematous disorders according to the following three principal categories: "mainly endogenous" (or "atopic") eczemas, "mainly exogenous" (or "contact") eczemas, and "dysregulatory microbial" eczemas. The latter group comprises eczemas caused by various kinds of functional derangement of epidermal protective properties (e.g., venous stasis, exsiccation of horny layer, seborrhea/hyperhidrosis, epidermal atrophy), which in turn permit the resident and/or transient microflora of the horny layer to induce inflammatory responses of eczematous pattern. Since morphological, topical, and other clinical attributes may change in the course of the very same eczematous disease, they are inappropriate for basic classification of eczemas and should be only employed as minor criteria to characterize the predominant "type" or subset (i.e., clinical appearance) of the specific eczema. The possible combination of eczemas representing two (or even three) categories in one patient leads to intermediate forms entirely in keeping with the division into three principal groups. The classification proposed is aimed at eliminating the terminological confusion as well as enabling reliable documentation for compatible statistics, and should consequently improve the sematic communication between dermatologists and other physicians.

UI MeSH Term Description Entries
D009626 Terminology as Topic Works about the terms, expressions, designations, or symbols used in a particular science, discipline, or specialized subject area. Etymology,Nomenclature as Topic,Etymologies
D003872 Dermatitis Any inflammation of the skin. Dermatitides
D004485 Eczema A dermatitis characterized by a spongiotic tissue reaction pattern occurring as a reaction to many endogenous and exogenous agents. Dermatitis, Eczematous,Eczematous Dermatitis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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