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56: ECZEMA

Shari Rone-Adams, DBA, MHSA, PT

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CONDITION/DISORDER SYNONYMS

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  • Atopic dermatitis (AD)

  • Atopic eczema

  • Infantile eczema

  • Nummular eczema

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ICD-9-CM CODES

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  • 692.0 Contact dermatitis and other eczema due to detergents

  • 692.1 Contact dermatitis and other eczema due to oils and greases

  • 692.2 Contact dermatitis and other eczema due to solvents

  • 692.3 Contact dermatitis and other eczema due to drugs and medicines in contact with skin

  • 692.4 Contact dermatitis and other eczema due to other chemical products

  • 692.5 Contact dermatitis and other eczema due to food in contact with skin

  • 692.6 Contact dermatitis and other eczema due to plants [except food]

  • 692.7 Contact dermatitis and other eczema due to solar radiation

  • 692.8 Contact dermatitis and other eczema due to other specified agents

  • 692.84 Contact dermatitis and other eczema due to animal (cat) (dog) dander

  • 692.89 Contact dermatitis and other eczema due to other specified agents

  • 692.9 Contact dermatitis and other eczema, unspecified cause

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ICD-10-CM CODE

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  • L20–L30 Dermatitis and eczema

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PREFERRED PRACTICE PATTERN1

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  • 7B: Impaired Integumentary Integrity Secondary to Superficial Skin Involvement2

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PATIENT PRESENTATION

A 15-year-old female presents with a dry, rough, red rash on her arms, legs, and trunk. The rash is itchy and inflamed. The itchiness is intense and she often scratches till it bleeds. During times of stress, the rash spreads to her face and neck. The rash has gotten worse over time. As a baby, she had small patches on her arm which have now spread to her legs and trunk. The patient states that when it is testing time at school the skin condition becomes worse.

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KEY FEATURES

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Description
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  • Eczema is a common group of skin conditions

  • Form of dermatitis

  • A chronic, relapsing, and inflammatory skin condition

  • Results in itchy, inflamed, irritated skin

  • Often has an inherited tendency to develop other allergic conditions such as asthma and hay fever

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FIGURE 56-1

Nummular eczema. Pruritic, round, nummular (coin-shaped) plaques with erythema, scales, and crusts on the posterior legs. (From Wolff K, Johnson RA, Saavedra AP. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 7th ed. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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Essentials of Diagnosis
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  • There are no laboratory tests used to diagnose eczema

  • Clinical features of the disease are used for diagnosis, including the itchiness and the biology and spread (appearance) of the lesions

  • Ruling out other skin diseases like contact dermatitis and seborrheic dermatitis is used to confirm the diagnosis

  • Skin lesion biopsies or skin cultures may be used to rule out other causes

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General Considerations
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  • There are three stages of the disease: Infantile, childhood, and adult

    • Often with latent phases in between

    • At each stage, ...

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