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Subacute eczema
Last reviewed: 05.07.2025
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[ Causes of subacute eczema
Contact allergy, contact irritation, atopic dermatitis, stasis dermatitis, nummular eczema, fingertip eczema, and fungal infections may present as subacute eczema. If there is no obvious history of atopy, a new skin irritant or exposure to an allergen should be sought. Stress may worsen the condition and contribute to its development, but is not the only cause.
Pathogenesis of subacute eczema
Podothra eczema may develop from acute (vesicular) eczema. It is the most common clinical manifestation of atopic dermatitis. Patients complain of dermatitis that lasts more than one week. The intensity of itching varies from mild to moderate and severe. The condition resolves without scarring when the triggering or contributing factors are eliminated. Excoriation and repeated exposure to aggravating conditions (water, cleaning or washing agents, irritants, or other common allergic or irritating factors) make the disease chronic.
Symptoms of subacute eczema
Erythema or scaling of various forms. Borders are often not clearly defined. Hyperemia can be weak or intense.
Treatment of subacute eczema
In the treatment of subacute eczema, group II-V steroid creams are prescribed twice daily with or without polyethylene occlusion. Occlusion accelerates the resolution of lesions by enhancing the absorption of the topical steroid. The duration of occlusion is determined individually, it should be limited and carried out under control. Steroid ointments are used twice daily without occlusion. The nonsteroidal topical immunomodulator pimecrolimus (Elidel cream 1%) can be applied twice daily to the affected areas of the skin and is especially effective in subacute eczema of the face or periorbital area. A burning sensation may occur initially, which disappears after a few days. This type of therapy is effective in chronic subacute eczema in atopic patients. Tar ointments and creams are an alternative in case of steroid-resistant lesions and have a moderately effective effect in some patients. Wet compresses should be avoided, as they dry the skin very much. The use of moisturizers is an essential part of daily therapy. Moisturizers work best when applied several hours after topical steroids. Application should be continued for several days or weeks after inflammation has subsided. Moisturizers should be applied frequently. Moisturizers are most effective when thoroughly massaged into the skin immediately after washing and gently patting the skin dry with a towel.
Creams with simple formulations (such as Aveeno) that do not contain ingredients commonly associated with allergens are better than lotions. Plain Vaseline jelly is an excellent moisturizer, with the advantages of being simple in formulation and not containing allergenic additives or irritating ingredients. However, Vaseline's acceptability to patients is limited by its greasiness. Mild bar soaps such as Dove are more helpful if the skin is not washed with soap frequently. Antibiotics are used for secondary bacterial infections.