I am frequently in receipt of letters which ask for advice about the cause or treatment of “eczema.” These are very puzzling because the term “eczema” alone does not mean anything. It used to be applied to any exudative inflammation of the skin which could not be otherwise classified. Modern skin specialists hardly use the term at all, or if so, very infrequently.
The term as it is still retained refers to a disease which is the result, according to a prominent Philadelphia skin specialist, of a possible mixture of ten factors. These are:
1. The hereditary or family predisposition factor.
2. The ichthyotic or dry skin factor.
3. Just the opposite of 2, it may occur on account of the seborrheic or oily skin factor.
4. The pyogenic or pus infection factor.
5. The mycotic or fungus infection factor, such as infection with ringworm or the cause of “athlete’s foot,” etc.
6. The focal intoxication factor, such as infected teeth or tonsils.
7. The nutritional factor, with particular attention to the possibility of starch indigestion.
8. The hypersensitiveness or allergic factor.
9. The nervous factor. This includes the actions of the subconscious nervous system in the excessive or decreased production of perspiration, for instance.
10. The diathetic state of eczemaasthmahay fever factor.
In any given case, the causes may be a combination of any two or three of these factors. Two or three groups would doubtless find certain factors as causative quite often.
For instance, eczemas of the dry skin variety tend to occur on the skin of the outside of the upper arm, the palms of the hands, the elbows and knees, and the shins. This goes with decided hereditary predisposition.
The oily or seborrheic variety occurs on the forehead, in the ears, on the neck, and over the upper parts of the chest, at the base of the neck, front and back.
Those who are bothered with skin eruptions of this sort are likely to have to fight them all their lives because they depend upon hereditary predisposition, bodily structure, plus the environmental factors. But with so comprehensive an idea of different factors in the causation, and a careful evaluation of them, much can be done to help.