ABSTRACT
In the subacute phase, the epidermis begins to thicken and the spongiosis lessens. In the chronic phase, the epidermis is thick (Figures 4 and 5) and similar in appearance to the epidermis in psoriasis, but the
‘folding’ of the interphase between the dermis and epidermis, present in psoriasis, is not seen in atopic eczema. The thickening is caused by hyperplasia of the keratinocytes. The dermis is infiltrated by mast cells, lymphocytes and eosinophils (Figure 4). As in psoriasis, the blood vessels in the dermis become more prominent. Langerhans and dendritic cells are increased in number in both the epidermis and dermis. The chronic phase (Figure 5) is often associated with persistent scratching and this has been linked to changes in the cutaneous nerves, which show demyelination, vacuolation and fibrosis.
