Death, pain and disability -- these are the things we fear the most. But what about a disease that tortured you in a different way -- with chronic and intolerable itching? An unendurable tickle that compelled you to scratch until you were bloody -- only to become maddeningly worse? A torment that started in early childhood, and could dog your entire life?

If you can imagine this, then you may be among the 2% afflicted with atopic eczema.

Often dismissed as a "nuisance" diagnosis, atopic eczema is actually a leading cause of missed work. Patches of dry, thickened skin cause relentless scratching that leads to sleeplessness, disfigured bodies and neurotic personalities. For centuries doctors blamed patients for their own illness -- believing that "neurodermatitis" was a psychological syndrome produced by compulsive scratching, ignoring the fact that the stress-related dermatitis occurs in the small of the back and inside ear canals where no fingers can reach. Specialists are still puzzed about the exact cause, although "atopic allergy" clearly runs in families with strong histories of allergic asthma and hay fever. Atopic patients are also sensitive to infections from staph bacteria and herpes viruses, so perhaps the eczema is caused by a disordered immune response.

Fortunately, the rash often improves with steroid creams rubbed onto intact skin after cleaning off with soap and water. Sufferers may want to immortalize February 27, 1990 as the day the FDA finally approved 1% hydrocortisone for sale over the counter -- ending the cheerless ritual of visiting a dermatologist every three months to beg for a perscription. Resist the temptation of enjoying frequent showers with boiling hot water that feels good on itchy skin -- a habit that only worsens the rash.

However, as is often the case with some of nature's puzzling inherited illnesses, atopic eczema may include a hidden benefit. For reasons none can explain, patients with atopic dermatitis often have high I.Q.s that land them in the upper range of intellectual function. Which is why, of course, you are reading this page!