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Eczema 

 

Introduction to Eczema

Atopic dermatitis(eczema) is a long-term (chronic) inflammatory state of the skin, which is characterized by an itching sensation (pruritus) in the affected areas (cheek and buttock region are more commonly affected).

This disorder is considered as the most common skin disorder in children of the developed countries wherein 15–20% of children are affected. Atopic dermatitis(eczema) affects about 1–3% of the adults wherein it may either be the persistent version or may have developed newly. Interestingly, the incidence is lower in countries, which have higher concentration of rural and agricultural areas.

Several investigators suggest that atopic dermatitis(eczema) is one of the symptoms of an underlying disorder, which is also responsible for other conditions such as asthma, food allergy and allergic rhinitis.1,2

Causes of Eczema

Several studies have indicated a number of complex processes by which atopic dermatitis(eczema) develops. These processes result in activation of numerous pathways of inflammatory reactions in the body which gives rise to the skin manifestations.

Following factors have been suggested as causative factors

  • Genetic structure of the affected individual
  • The environment he/she lives in
  • Defects in the functioning of the skin cells and tissues
  • Response of the body to the irritating agents such as dust 
Children whose parents suffered from atopy or eczema are more prone to develop this disorder. The risk is considered greater in children whose mother suffered from atopy.2,3

Signs and Symptoms of Eczema

Atopic dermatitis(eczema) is most commonly characterized by pruritus. The affected areas of skin are inflamed, red and itchy. The pruritus may at times be severe enough to cause sleep disturbances, irritability and generalized stress.

The continuous scratching of the skin can cause secondary changes in the skin such as thickening of the skin, formation of scaly skin and breakdown in the continuity of skin, which may give way for infection.

In infants and young children, the rashes occur mainly on the face and scalp while in case of teenagers and young adults, the patches typically occur on the hands and feet. However, any area such as the bends of elbows, backs of the knees, ankles, wrists, face, neck and upper chest region may be affected. It has been also noted that about 50–80% individuals who suffer from atopic dermatitis(eczema) are either sufferers of concomitant asthma or allergic rhinitis or may develop these disorders at a later stage in life.4

The factors that may trigger an itch reaction in the individuals suffering from atopic dermatitis include soaps, detergents, disinfectants, contact with juices from fresh fruits or vegetables, dust mites, hair of pets, pollen and dandruff. 3

Diagnosis of Eczema

The diagnosis of atopic dermatitis(eczema) is based on a comprehensive review of the history of the condition and signs and symptoms noted. The doctor performs physical examination to record the affected areas and evaluate the severity of the condition. Occasionally certain blood tests may be advised to rule out the presence of any other disorders.

Treatment of Eczema

Treatment of Eczema

Atopic dermatitis(eczema) is a chronic condition, which requires regular therapy for quite a long period of time. It involves simple home measures to reduce the itch, administration of certain medications and certain specialized 
 

Complications of Eczemas

The chronic dermatitis may be associated with complications such as infection of the affected areas and permanent scarring. Individuals who suffer from atopic dermatitis(eczema) during their childhood are at a higher risk to develop asthma and allergic rhinitis when compared to others.

Prevention of Eczema

Although the occurrence of atopic dermatitis(eczema) cannot be prevented, the flare up of its commonest feature, pruritus can be effectively prevented. Avoidance of any particular product or other substances that are associated with allergy is beneficial. Repeated bathing in a single day can make the skin dry and hence should be avoided. Use of mild soaps that do not leave the skin excessively dry after bathing should be used. Moisturizing lotions may be applied if the skin tends to be dry after washing or bathing.

Written by: Healthplus24 team
Date last updated: July 18, 2011

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References 
  1. Leung DYM, Boguniewicz M, Howell MD, Nomura I, Hamid QA. New insights into atopic dermatitis. J Clin Invest. 2004; 113(5): 651–657.
  2. Brown S, Reynolds NJ. Atopic and non-atopic eczema. BMJ. 2006; 332: 584–588.
  3. Beltrani VS, Boguneiwicz M. Atopic dermatitis. Dermatology Online Journal. 2003; 9(2): 1.
  4. Correale CE, Walker C, Murphy L, Craig TJ. Atopic dermatitis: A review of diagnosis and treatment. Am Fam Physician. 1999; 60: 1191–210.
  5. Buys LM. Treatment options for atopic dermatitis. Am Fam Physician. 2007; 75: 523–528, 530.
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