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ECZEMA (ATOPIC DERMATITIS)

Eczema or atopic dermatitis is a chronic skin condition in which the skin becomes red, itchy, cracked, inflamed and rough. This condition is very common, not contagious and can become severe periodically. Eczema can be seen in any part of the body.

The exact cause of eczema is unknown.It is known to be commonly accompanied with allergic conditions such as hay fever and asthma. In some children, food allergies may cause eczema. This condition can be treated with medications and lifestyle modifications.

The following are the eight different types of eczema:

  • Contact dermatitis: The skin may develop reaction to substances such as chemicals and other skin irritants.
  • Atopic dermatitis: It is most common form of eczema, starts usually at childhood
  • Hand eczema: Eczema affecting only hand is called hand eczema. It is commonly seen in people working in hairdressing, cleaning and sanitation departments.
  • Dyshidrotic eczema: This type of eczema causes small blisters to form on hand and feet. It is more common in women than in men.
  • Nummular eczema: Nummular is a latin word which means coin. The people affected with this type of eczema have coin-shaped spots hence, it is called as nummular eczema.
  • Neurodermatitis: It is similar to atopic dermatitis, thick and scaly patches are present on the skin.
  • Stasis dermatitis: In this type, fluid from the weakened veins leak into skin causing swelling, redness, itching and pain.
  • Seborrheic dermatitis: It commonly occurs in the scalp as red skin, scaly and greasy patches.

SIGNS AND SYMPTOMS

The following are the characteristics of the eczematous rash:

  • Itchy
  • Dry and sensitive
  • Red in color
  • Rough, dark, leathery or scaly
  • Appear as raised bumps over the skin
  • Oozing or crusting in the later stages

The types and severity of the rashes condition vary among individuals. In some people, itching is so bad that the person tends to scratch until it bleeds, and this makes eczema worse. This is referred as the itch-scratch cycle.

In infants, the rash occurs on the scalp and cheek. In children from the age of 2 years till puberty, the rash most commonly occurs on the neck, wrists, ankles, and the crease between buttock and legs. In adults, the rash covers most area of the body.

CAUSES

The exact cause of eczema is unknown; however research hints that it may be caused by genetic and environmental factors. The probability of children developing eczema is high when both the parents are known to have this condition.

The following are the some of the environmental factors that are known to cause eczema:

  • Allergens such as dust, mites, pollen, mould and dandruff.
  • Microbes including bacteria, virus and fungi.
  • Extreme conditions like high and low humidity, very cold or hot temperature and exertion from exercise.
  • Foods including nuts, eggs, soy products and wheat.

Hormonal changes and stress may worsen eczema.

RISK FACTORS

Some of the risk factors for eczema are as follows:

  • Family history of eczema
  • Poor immunity
  • Allergies

COMPLICATIONS

Complications of eczema are as follows:

  • Young children who develop eczema are at higher risk of developing hay fever and asthma during adulthood.
  • Repeated scratching of itchy skin causes open sores, which may get infected with micro-organisms and lead to skin infection.
  • In person affected with eczema, the itch-scratch cycle may cause poor sleep.
  • In some people with eczema, itch and rash may cause low self-esteem.

DIAGNOSIS

The doctor may first discuss the medical and family history of the patient and then check for signs and symptoms of eczema.

Patch test: This test is done to determine if eczema has been caused due to allergic substances such as fragrances, rubber, metals, resins, hair dyes, and preservatives. This test involves exposing your skin to certain extracts of substances (chemicals) and then evaluating your skin reaction.

TREATMENT

The main aim of eczema treatment is to control the itch, heal the skin, and prevent flares and infections.

Medications:

The following medications are used to treat the eczema:

  • Creams, solutions, foams, and ointments containing corticosteroids such as hydrocortisone help to control inflammation
  • Immunosuppressant drugs such as cyclosporine, methotrexate, pimecrolimus, and tacrolimus to treat the body’s over active immune system
  • Ointment containing non-steroidal anti-inflammatory drugs help to reduce pain and inflammation
  • Moisturizers help to retain moisture, prevent skin from drying, decrease redness and itching
  • Antihistamines help to relieve itching
  • Antibiotics to treat the skin infection

Phototherapy

Moderate to a severe form of eczema is treated with help of the following phototherapy techniques.

UV light therapy: The dermatologist may treat the affected area of skin under UVA rays, UVB rays or a mixture of both the rays.

PUVA therapy: In this technique, the skin is made more sensitive to UVA light by applying psoralen.

Home remedies

The following are the simple home remedies which are helpful to treat eczema:

  • Regular application of moisturizer prevents the skin from drying.
  • Prefer warm water showers as they are gentle to the skin.
  • Wear comfortable cotton clothes that are skin friendly.
  • Avoid stress with exercise or yoga.

PREVENTION

Eczema can be prevented by following ways:

  • Taking a shower daily, at least once
  • Wearing gloves while working
  • Bathing with lukewarm water
  • Staying away from allergens
  • Cleaning clothes regularly
  • Avoiding harsh soaps
  • Keeping skin moist
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