Eczematous rashes: Clinical

To be retired ⓘ

00:00 / 00:00



Eczematous rashes: Clinical

USMLE® Step 2 questions

0 / 11 complete


USMLE® Step 2 style questions USMLE

of complete

An 8-month-old infant is brought to the family doctor by her mother who has noticed a red rash developing on her daughter’s face. According to the mother, this rash appeared a few weeks ago and is worsening. She thinks it may have appeared after her daughter opened her aunt’s makeup box and smeared mascara over her face. She has also noticed her daughter scratching at the red areas intermittently. Vital signs are all within normal range. Examination shows multiple small papules, pustules, and vesicles around the daughter’s mouth, and scattered lesions near the nostrils.

Which of following is the most appropriate initial treatment?

Memory Anchors and Partner Content


An eczematous rash, or simply eczema, is a group of inflammatory skin conditions characterized by redness, itching, and sometimes oozing vesicular lesions, which may become scaly, crusted, or hardened.

This group includes atopic dermatitis, contact dermatitis, seborrheic dermatitis, dyshidrosis, nummular or discoid dermatitis, and stasis dermatitis.

Now, every type of eczema has a different set of additional symptoms, and also the area of the skin on which the symptoms appear tends to be different.

That’s why diagnosis is based mostly on the history and physical examination, and a patch test may be done to determine whether there is an allergic component. Finally, in uncertain cases, a skin biopsy may be useful.

Atopic dermatitis, also called atopic eczema, is a chronic inflammatory skin disease that’s particularly common among young children, but can last into adulthood.

Atopic dermatitis results from an allergy, more specifically, it happens when the immune system attacks the skin causing a dry, itchy rash on flexor surfaces of the body, areas like the creases of the wrists, the insides of the elbows, and the backs of the knees, as well as exposed skin surfaces like on the face, the hands, and the feet.

Atopic dermatitis can worsen in the presence of allergens like cigarette smoke, mold, and dust mites, as well as changes in the weather, and even emotional stress.

Although it usually causes patches of red itchy skin that come and go, the skin can occasionally even blister and peel. Over time, the skin can become lichenified, which literally means turned to leather.

Atopic dermatitis is generally a clinical diagnosis, based on evidence of itchy skin, plus three or more criteria, which include having a history of dermatitis involving the skin creases, visible dermatitis involving flexural surfaces, personal or family history of asthma or hay fever, presence of generally dry skin within the past year, and either symptoms beginning in a child before the age of 2 years or dermatitis affecting the cheeks or dorsal aspect of extremities in children before the age of 4 years.


Copyright © 2023 Elsevier, its licensors, and contributors. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Cookies are used by this site.

USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.