What Is Papular Eczema?

Papular eczema is a form of atopic dermatitis, a chronic skin condition characterized by an itchy rash 13. One of several types of this widespread skin disorder, papular eczema strikes disproportionately among people of African and Asian descent and is far less common in Caucasians, according to DermatitisFacts.com. The condition, which has no cure, has many characteristics in common with other forms of eczema.


The most characteristic symptom of papular eczema, sometimes called lichen simplex, is a scattering of tiny pinhead-sized bumps, or papules, on the skin. They may be bright or dull red in color and occur most frequently on the flexor surfaces of the extremities, according to F. M. Dearborn, author of “Diseases of the Skin with Illustrations.” Medical professionals occasionally misdiagnose this type of eczema as folliculitis, an inflammation of hair follicles 2. The papules sometimes become filled with fluid, which may lead to weeping lesions, particularly if the papules are broken open by repeated scratching.


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All forms of eczema, including the papular strain, affect more than 30 million Americans, according to the National Eczema Foundation. Underlining the chronic nature of this skin disorder is the fact that 65 percent of all eczema patients are diagnosed within the first year of life, with an additional 25 percent diagnosed by age five. Although some patients diagnosed with eczema as children may experience some lessening of symptoms as they mature, most will continue to suffer from eczema for the rest of their lives.


Medical researchers have been unable to identify the cause of papular eczema; according to the Mayo Clinic, it may be triggered by a combination of dry, irritated skin and some form of immune system dysfunction 3. Stress and emotional disorders can cause a worsening of symptoms but do not cause the skin disorder. Although not fully researched, a hereditary predisposition to eczema is suspected, MayoClinic.com reports.


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Diagnosis of eczema is almost always based on a combination of visual examination of skin lesions with an interview that includes family medical history, including any incidence of eczema, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases 24. There are no laboratory tests for the diagnosis of eczema.


Left untreated, papular eczema may develop into neurodermatitis, a condition in which patches of affected skin become thick and leathery, according to the Mayo Clinic 3. Repeated scratching of eczema lesions may lead to infection.


While there is no cure for papular eczema, a wide array of medications and therapies offer symptomatic relief. Such options include phototherapy, the exposure of skin lesions to controlled levels of ultraviolet A or B light, and medications such as:

  • antibiotics
  • corticosteroid creams or ointments
  • immunomodulators
  • oral antihistamines
  • oral corticosteroids