A common skin condition that affects many children is eczema. Otherwise known as atopic dermatitis, eczema appears as patches of dry, red, irritated, and extremely itchy skin. Eczema symptoms may be similar to various skin conditions, so it is not impossible to mistake this for a different skin problem, which can result in misdiagnosis, wrong treatment, and worsening of the condition. If you suspect that your child may have eczema, it is imperative that you consult with a paediatric dermatologist clinic in Singapore to get an accurate assessment and diagnosis.
Skin conditions with symptoms similar to eczema
A paediatric dermatologist in Singapore can guide parents in navigating chronic skin conditions in children, such as eczema. A key factor in getting a conclusive diagnosis is knowing and understanding the differences between eczema and other skin conditions that mimic it. Having a correct diagnosis is critical and gives you and your child an assurance that the proper treatment is set in place instead of depending on the usual eczema treatments that may not be effective or cause additional harm to the skin.
Below are the usual skin conditions that are frequently mistaken for eczema in children and their identifiable characteristics that differentiate them from true eczema.
1. Seborrheic Dermatitis
Also known as cradle cap, seborrheic dermatitis often appears in infants as early as in their first week after being born. Seborrheic dermatitis can show as patches on the skin that are red, greasy, and scaly. It can form on the diaper area, eyebrows, eyelids, sides of the nose, scalp, and skin folds. Seborrheic dermatitis on the scalp (cradle cap) may indicate severe eczema.
Paedriatric dermatologists are able to distinguish seborrheic dermatitis from eczema by noting the following:
- Age of onset: May appear in the first six weeks of life and heals within six to twelve months. Usually develops after three to six months in infancy and tends to be chronic.
- Appearance: Seborrheic dermatitis are greasy, yellow, and thick scaly patches of skin that are less itchy, while eczema occurs as intensely dry, red, and itchy spots on the skin which usually crusts when scratched.
- Itch: Seborrheic dermatitis is slightly itchy at most, while eczema is intense and agonizing.
- Location: Seborrheic dermatitis affects the scalp, mid-forehead, eyebrows, nasal folds, ears, skin folds and diaper area. Eczema appears on the cheeks, arms, legs, elbow and knee creases.
2. Contact Dermatitis
As suggested by its name, contact dermatitis is a type of inflammatory condition that occurs when the skin reacts to a substance it comes in contact with. Contact dermatitis may either be irritant or allergic in nature.
Paedriatric dermatologists are able to distinguish contact dermatitis from eczema by noting the following:
- Appearance: Contact dermatitis have sharp borders and are contained within the area of contact. It can also be determined by its specific shape or asymmetric appearance (e.g. only affecting one hand). Eczema can be distinguished by its symmetric characteristic, ill-defined borders, and areas of the skin where it is usually distributed.
- Cause: External triggering factors like irritants (acidic food, harsh skin products, saliva, urine) or allergens (fragrance, nickel, preservatives).
- History: Contact dermatitis is identifiable by its direct connection to a provoking substance like a specific plant or laundry detergent that has come in contact with the skin. Eczema, on the other hand, is persistent and recurring. It is also linked to your family medical history, especially for lineage with a history of hay fever or asthma.
3. Psoriasis
Psoriasis is not common in children, but in rare occasions, it may develop on the scalp or in the diaper area, appearing as red, inflamed, and itchy patches on the skin.
Paedriatric dermatologists are able to distinguish psoriasis from eczema by noting the following:
- Appearance: The borders of psoriasis are sharp and well-defined, while eczema usually blends into normal skin and has a poor outline. Psoriasis has a thick and silvery-white scale covering a bright red plaque of skin. Eczema may have subtle to no scale or when chronic, skin that appears thick and leathery.
- Auspitz Sign: Psoriasis bleeds when the scale is peeled from the skin, while eczema does not have this symptom.
- Location: Psoriasis may form in different areas of the body such as the belly button, buttocks, ears, elbows, hand and scalp. Eczema develops on the cheeks, arms, legs, elbow and knee creases.
4. Tinea
Otherwise known as ringworm, tinea is a fungal skin infection brought about by dermatophytes.
Paedriatric dermatologists are able to distinguish ringworm from eczema by noting the following:
- Appearance: Tinea is shaped like a ring with a border that is active, raised, reddish and scaly, and a center that is clear. Eczema differs as it appears patchy with blurred borders.
- Diagnosis: Determined through skin scrapings that are examined under a microscope. Paedriatric dermatologists can perform a clinical diagnosis to confirm eczema.
- Location: Tinea spreads from the center going outward, which enlarges the ring. Eczema spreads by forming new patches in specific areas.
- Treatment response: Tinea is treated quickly with anti-fungal cream, while eczema often needs moisturisers and steroid creams to resolve.
5. Scabies
Scabies is an allergic reaction to a mite called Sarcoptes scabiei. This type of allergy is highly contagious and causes extreme itching.
Paedriatric dermatologists are able to distinguish scabies from eczema by noting the following:
- Appearance: Scabies appear as grayish-white lines that are fine and thread-like, called burrows. When severely scratched, the burrows may be difficult to find as they become tiny red bumps, which can look a lot like eczema.
- Location: Scabies can be found in the armpits, elbows, belt line, finger webs, lower abdomen, wrists, palms, and soles.
Important questions to ask when differentiating eczema from other skin conditions
A clear cut way that can help distinguish eczema from impostor skin conditions is to ask key questions:
- What is the appearance of the skin? Take note of the specific characteristics of the lesion. For example, eczema is itchy and scaly, while seborrheic dermatitis is greasy and yellow.
- Where is it located? Other skin conditions that share the same symptoms with eczema usually appear in other parts of the body where eczema does not form.
- Is it contagious? Tinea and scabies are contagious. Check other members of the family if they are also affected by any kind of itching.
For a more accurate diagnosis and treatment, you can always consult with a paediatric dermatologist in Singapore.