Key Differences – Eczema vs Hives
The key difference between Eczema and Hives is that eczema is an inflammation of the skin, characterized by itching, scaling, redness, oozing and crusting which tends to be a long standing or recurrent disease while hives or urticaria is a characteristic skin lesion that occur in relation to allergy, characterized by slightly elevated, reddish, itchy, larger multiple patches all over the body that tend to occur very rapidly and resolve quickly with the treatment.
What is Eczema?
Eczema is also known as dermatitis. Eczema is characterized by itchy, erythematous, vesicular, weeping, and crusting patches. The exact cause of eczema is unclear. One possibility is a dysfunctional interplay between the immune system of the body and the skin. Common symptoms of the eczema are redness, skin swelling, itching and dryness, crusting, flaking, blistering, cracking, oozing, or bleeding. Frequent scratching of the lesions causes further damage to the skin. This is typically treated with moisturizers and steroid creams. Eczema can be associated with other immune-mediated diseases such as asthma but not always. It can affect any age group from infants to elderly. However, the appearance of eczema may differ according to age groups. Although the eczema is not curable, it can be controlled very well with treatment. However, eczema is known to settle spontaneously in certain people. If it affects a major portion of the skin, the patient can get complications such as infections, dehydration, hypothermia, etc. Eczema is a common condition in a dermatology clinic and needs long term follow-up and treatment.
What is Hives?
Hives or urticaria occurs in relation to allergen exposure. This is very common with food allergy. Once the person is exposed to an allergen, it triggers skin associated mast cells to release histamine which is a chemical mediator in an allergic reaction. Histamine causes itching and skin edema giving rise to Hives. This can be associated with other serious allergic manifestations such as angioedema (swelling around the mouth), wheezing due to bronchospasms and more serious anaphylaxis. Hives can be treated with antihistamines and a short cause of steroids. They are short lasting and respond quickly to the treatment. Sometimes they may persist for few days or recur in few days. Hives is a common presentation to general practitioners or family doctors, and it does not require a long-term follow-up. It is important to avoid exposure to known allergens if hives is recurrent.
What is the difference between Eczema and Hives?
Definition of Eczema and Hives
Eczema: Eczema is an inflammation of the skin, characterized by itching, scaling, redness, oozing and crusting which tends to be a long standing or recurrent disease
Hives:Hives or urticaria is a characteristic skin lesion which occur in relation to allergy, characterized by slightly elevated, reddish, itchy, larger multiple patches all over the body that tend to occur very rapidly and resolves quickly with the treatment
Cause of Eczema and Hives
Eczema: Eczema is an immune-mediated disease which occur spontaneously among vulnerable people.
Hives: Hives is a temporary skin manifestation which occur commonly with allergy.
Characteristic Features of Eczema and Hives
Distribution
Eczema: Eczema commonly occurs in extremities and flexural surfaces such as behind the knees. In infants, it tends to occur on the face.
Hives: Hives generally occur all over the body.
Appearance
Eczema: Eczema is characterized by scaling, oozing and crusting of the skin.
Hives: Hives is characterized by multiple, itchy, elevated patches on the skin.
Associations
Eczema: Eczema can be associated with immune-mediated diseases such as Asthma.
Hives: Hives may occur more frequently among people who are prone to allergic reactions.
Duration of the illness
Eczema: Eczema tends to be long lasting with recurrent episodes.
Hives: Hives occur as isolated, single episodes most of the times.
Complications
Eczema: Eczema can lead to infections, dehydration and hypothermia when severe.
Hives: Hives are usually self-limiting and do not lead to long-lasting damage.
Treatment
Eczema:Eczema is treated with moisturizing creams and steroid local applications or systemic treatment.
Hives: Hives are treated with antihistamines and a short course of steroids.
Follow up
Eczema:Eczema needs long term Dermatology follow up.
Hives: Hives do not require long term follow up unless recurrent.
Long standing skin damage
Eczema:Eczema can lead to long-standing skin damage with scars.
Hives: Hives do not cause long standing damage.
Image Courtesy: “Dermatitis2015” by James Heilman, MD – Own work. (CC BY-SA 4.0) via Commons “EMminor2010” by James Heilman, MD – Own work. ( CC BY-SA 3.0) via Commons
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