For a diagnosis of chronic eczema, which characteristic sign is often present upon examination?

In the diagnosis of chronic eczema, crusts and lichenification are key signs that indicate the condition's ongoing nature. Lichenification refers to the thickening and leathery appearance of the skin that develops due to prolonged scratching or rubbing in response to itching, which is a common feature in chronic eczema. This thickening results from a cycle of inflammation and injury to the skin, causing changes in its texture.

Crusts can form from the exudation of fluid due to inflammation, leading to the development of a crusty surface that often occurs in areas where the skin has been scratched or irritated. These features reflect the chronicity of the eczema, as they indicate that the skin has been subjected to long-term inflammation and trauma.

In contrast, other options do not align with the characteristic signs of chronic eczema. Silvery scales are typically associated with psoriasis, while pustules and vesicles are more indicative of acute skin conditions, such as contact dermatitis or infections. Plantar papules might refer to a different dermatological condition entirely and are not a hallmark of eczema. Understanding these distinctions is vital for accurate diagnosis and treatment in dermatology.