Eczema rash on neck
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Eczema Rash on Neck: Insights and Treatments
Prevalence and Epidemiology of Neck Eczema
Eczema, a chronic inflammatory skin condition, can manifest in various parts of the body, including the neck. A study involving 3,684 patients with eczema found that 21 individuals (4%) had eczema localized to the neck1. This study highlighted that contact dermatitis was prevalent in 76% of neck eczema cases, indicating that external irritants or allergens often trigger this condition1.
Clinical Presentation and Symptoms
Patients with neck eczema often experience severe pruritus (itchiness) and erythema (redness). In a case study of a 62-year-old African-American female, the patient presented with indurated, erythematous plaques on the neck, which were severely pruritic and progressively enlarging over three weeks2. This case underscores the chronic and often debilitating nature of neck eczema, which can significantly impact the quality of life.
Treatment Options and Effectiveness
Upadacitinib for Atopic Dermatitis
For patients with moderate-to-severe atopic dermatitis (AD), including those with neck involvement, the Janus kinase 1 inhibitor upadacitinib has shown promising results. In a study of 72 Japanese patients, upadacitinib combined with topical corticosteroids significantly reduced Eczema Area and Severity Index (EASI) scores for various rash types, including erythema and excoriation3. However, the effectiveness of upadacitinib for erythema on the head and neck was lower compared to other body parts, suggesting that neck eczema might be less responsive to this treatment3.
Irritant Dermatitis from Bath Emollients
In some cases, eczema on the neck can be exacerbated by irritant reactions to topical treatments. A 7-year-old boy with mild eczema developed severe erythema and desquamation on his neck and other flexural sites after using Oilatum Plus, a bath emollient containing triclosan and benzalkonium chloride4. This case highlights the importance of monitoring for potential irritant reactions, especially in patients with compromised skin barrier function4.
Conclusion
Eczema on the neck is a relatively common manifestation of the condition, often triggered by contact dermatitis. While treatments like upadacitinib show effectiveness for various types of eczema rashes, neck eczema may require tailored approaches due to its unique response patterns. Additionally, clinicians should be cautious of potential irritant reactions from topical treatments, which can exacerbate the condition. Understanding these nuances can help in managing and alleviating the symptoms of neck eczema more effectively.
Sources and full results
Most relevant research papers on this topic
Eczema of the Face, Scalp and Neck: An Epidemiological Comparison by Site
Eczema of the face, scalp, and neck is more common in females, with contact dermatitis being more prevalent in ear and neck eczema, and endogenous/unclassifiable eczema in lip and scalp eczema.
Observational StudyIndurated erythema of the neck and upper back
Indurated erythema of the neck and upper back is a common presentation in patients with lymphadenopathy and leukocytosis, but may not be a primary diagnosis.
Case ReportTherapeutic effectiveness of upadacitinib on individual types of rash in Japanese patients with moderate‐to‐severe atopic dermatitis
Upadacitinib is effective for all atopic dermatitis rash types, particularly excoriation and erythema, but head-and-neck erythema may be less responsive.
Non-RCTShiitake dermatitis
Oilatum Plus bath additive may cause irritant reactions in patients with atopic eczema, even when used according to manufacturers' recommendations.
Case Report
Highly CitedA skin rash to remember
Eczema herpeticum, with secondary staphylococcal superinfection, is the most likely diagnosis in this case.
Case Report
Rigorous JournalAtopic dermatitis.
Atopic dermatitis is a chronic inflammatory dermatosis characterized by pruritus, xerosis, and a close association with IgE mediated sensitization to aeroallergens and foods.
Allergic contact dermatitis of head and neck by propolis contained in a shampoo
Propolis in Propomel shampoo may cause allergic contact dermatitis of the head and neck, with the shampoo causing intense pruritus and eczema.
Case Report