The favourite locations for atopic eczema include the hands, especially the fingers and knuckles and the edge of the palm. The small red areas of broken skin are vesicles characteristic of acute hand eczema that have been broken by scratching. They are extremely itchy and are readily scratched open. Gradually the skin begins to peel off and thicken. As with this patient, eczema of both the acute and chronic phase is often found on the same hand.