How is eczema diagnosed?

Several types of eczema with differing aetiologic factors may display a similar clinical picture, which makes an elaborate anamnesis mandatory. For diagnosing eczema we recommend the following diagnostic procedure:

I. Anamnesis

• Onset of disease
  
• Time flow of eczema and relations to certain activities (season, time of day, occupation, improvement during holidays, hobbies, stress etc.)
  
• Does the localisation of eczema correlate with exposure to possible triggers (direct skin contact, food, animals)?
  
• Which treatments have been performed (local/systemic) and how was the patient’s experience with these?
  
• Contact to possible irritants and allergens (chemicals, detergents, metal, plants, leather or rubber gloves etc.)
  
• Where is the eczema localised (hands, feet, face, neck, flexural folds of the extremities)?
  
• Former dermatitis (atopic anamnesis)
  
• Family history
  

II. Clinical examination

• Total-body examination and documentation of skin changes, photography if indicated
  
• Atopic criteria
  

III. Laboratory tests and skin tests (if indicated)

• IgE, specific IgE
  
• Prick testing
  
• Patch testing
  
• Atopy patch test
  
• Exposition tests
  
• Mycology, bacteriology
  
• Histopathology