Name of the Condition

• Intrinsic (Allergic) Eczema (ICD-10 Code: L20.84)
• Also known as intrinsic atopic dermatitis or non-allergic eczema.

Summary

Intrinsic (allergic) eczema is a chronic skin condition characterized by inflamed, itchy, and dry skin. Unlike extrinsic eczema, it does not involve the body's typical allergic response. It often presents with persistent rashes that may be triggered by skin sensitivities rather than external allergens.

Causes

• Suspected to be linked to genetic factors and immune system abnormalities.
• May arise from skin barrier dysfunction, leading to increased susceptibility to irritants.

Risk Factors

• Family history of eczema or other atopic diseases (such as asthma or hay fever).
• Environmental factors that irritate sensitive skin, such as low humidity and harsh personal care products.

Symptoms

• Dry, itchy, and inflamed patches of skin.
• Thickened skin from scratching (lichenification).
• Redness and possible blistering in affected areas.

Diagnosis

• Primarily based on clinical examination and patient history.
• Patch testing may be conducted to rule out extrinsic causes, though not typically indicating intrinsic eczema.

Treatment Options

• Topical corticosteroids or calcineurin inhibitors to reduce inflammation.
• Emollients to maintain skin hydration and barrier function.
• Antihistamines for itch relief, though less effective compared to extrinsic eczema.

Prognosis and Follow-Up

• Chronic condition that may improve with age or persist long-term.
• Regular dermatological reviews are essential to adapt treatment plans as needed.

Complications

• Secondary bacterial or viral infections from skin barrier disruption.
• Psychological effects, including anxiety or depression due to persistent symptoms.

Lifestyle & Prevention

• Use fragrance-free skin care products and detergents.
• Maintain skin hydration with regular application of moisturizers.
• Avoid known irritants or activities that exacerbate the condition.

When to Seek Professional Help

• Worsening or unmanageable itching and rash.
• Signs of skin infection, such as increased redness, swelling, or oozing.
• Significant impact on daily activities or emotional well-being.

Additional Resources

• National Eczema Association National Eczema Association
• American Academy of Dermatology American Academy of Dermatology

Tips for Medical Coders

• Ensure correct differentiation between intrinsic (L20.84) and other forms of eczema, such as contact dermatitis.
• Verify comprehensive clinical documentation, including symptom presentation and any relevant family history.