Facial eczema (synonyms: Facial allergy, facial redness; ICD-10-GM L30.9: Dermatitis, unspecified) can have many different causes and is often very distressing for the affected person, as the face is of high aesthetic importance.
According to etiology (causes), facial eczema can be classified as follows:
- Contact allergic facial eczema – about 50% of facial eczema.
- Toxic-irritant facial eczema – 15-20% of facial eczema.
- Atopic facial eczema (neurodermatitis) – 10-20% of facial eczema.
- Seborrheic facial eczema (seborrheic dermatitis) – 3-6% of facial eczema.
- “Airborne Contact Dermatitis” (synonym: aerogenic allergic contact dermatitis; caused by wind-borne (“airborne”) components of plants (essentially the composite family) and by chemical products, perfumes or drugs) – about 2% of facial eczema.
Furthermore, one distinguishes an acute stage from a chronic stage.
The stages of acute eczema:
- Stage erythematosum – acute eczema reaction with erythema (areal redness of the skin) confined to the site of skin irritation; mild cases heal after a few days in this stage.
- Stage vesicolosum – with stronger reaction formation of vesicles (small vesicles; rarely larger than a pinhead), which are filled with clear fluid or stage papulosum, that is, formation of papules (no nodules); this is usually accompanied by pruritus (itching)
- Stage madidans – bursting of the vesicles (vesicles).
- Stage crustosum – crusting of the weeping areas.
- Stage squamosum – scaling or desquamation (phase of healing); thereafter:
- Resterythem (residual redness) or.
- Restitutio ad integrum (restoration of integrity, i.e., complete healing).
The stages of chronic eczema:
- Simultaneous and alternating coexistence of the different forms of reaction (erythema/redness of the skin, vesicles (vesicles), papules (nodules), crusta (crusts), squama (scales)); often scratch-related marks.
- Lichenification (extensive leathery change of the skin) due to:
- Thickness increase
- Coarsening of the skin structure
Facial eczema can be a symptom of many diseases (see under “Differential diagnoses”).
Course and prognosis: The course and prognosis depend on the cause of the disease. Possible complications may arise from co-involvement of the eyes (eg, in herpes infections, rosacea/inflammatory skin disease).
