What Is Eczema?
Eczema is a descriptive term for a chronic skin condition that usually begins in early childhood. It is seen most commonly in individuals who have family members who have asthma and hay fever. This is not to say that eczema is a classical allergic disease. There seems to be general agreement that this condition is inherited because of the complete loss or relative lack of a skin protein.
There are criteria that must be met before the diagnosis of eczema is considered. In most patients, the condition began in childhood. Patients develop plaques of weeping, oozing skin that are very itchy. A personal or family history of eczema, asthma, and/or inhalant allergies is helpful. In older children or adults, the lesions of eczema tend to occur in the folds of the skin in front of the elbows and in the folds of skin behind the knees. Eczema tends to improve in most patients as they get older.
The belief that the cause of eczema seems to be a defect in the production of a particular skin protein (filaggrin) is currently quite popular. All of the other problems that seem to be present in those afflicted include dry skin, hyper-reactivity to wool, itching during sweating, colonization by pathogenic staph bacteria, predisposition to disseminated herpes simplex infections, and a variety of immunologic abnormalities.
There is a debate about which comes first in atopic eczema, the itching or the rash. This is analogous to the chicken and egg controversy. It really does not matter. When the rash is in an acute stage, it is weepy and oozy. Later after the patient has been rubbing and scratching for some weeks, it becomes a plaque of thickened skin. This is called lichenification.
Atopic eczema has a typical distribution on the surface of the skin; this can be quite helpful in making the correct diagnosis. In crawling children in diapers, the rash is frequently seen on the elbows and knees but spares the diaper area. In older children and adults, the rash is often present in the folds of skin opposite to the elbow and kneecap but spares the armpits. Other areas commonly involved include the cheeks, neck, wrists, and ankles.
Atopic eczema (atopic dermatitis) is one of a number of eczematous eruptions that need to be distinguished. This is important because treatment depends on the correct diagnosis. We’ll take a look at the listed types on the following slides.
Atopic eczema is an inherited skin condition more common in individuals with a personal or family history of eczema, inhalant allergies like asthma or hay fever. Patients develop weeping, oozing, itchy lesions in a characteristic distribution. The severity depends to a great extent on the amount of moisture in the skin.
Atopic eczema is less common in very humid environments and is harder to control in arid areas in the wintertime. It often begins in infancy and improves in most people as they reach adulthood.
Contact dermatitis is a dermatitis that occurs in response to exposure to an irritant or allergenic substance. Irritants cause skin damage by producing direct toxic damage to the skin cells. Contact allergens are not necessarily irritating or toxic but are recognized by the immune system. Once the immune response is stimulated, a dermatitis occurs at the site of exposure.
Seborrheic dermatitis is a chronic recurrent dermatitis, and it is probably the most common of all rashes in adults. The rash characteristically appears on the scalp, forehead, brows, ears, the folds that extend from the nose to the lips (nasolabial folds), middle of the chest, and middle of the back. It occurs in infants as cradle cap. Its course is distinguished by periods of improvement followed by flares.
With nummular eczema, round plaques of eczematous skin often appear on the lower legs. It often is seen in the elderly and seems to be associated with dry skin.
Lichen simplex chronicus is a localized, thickened area of skin caused by itching and rubbing. Although there is usually some inciting cause, the origin of the problem is entirely obscured by the eruption. Any of the eczematous eruptions can evolve into lichen simplex chronicus if rubbed long enough.
Stasis dermatitis usually occurs on the lower legs of patients who have sustained damage to the valves present in the large veins responsible for returning blood to the heart. These valves, along with muscular contractions of the leg muscles, help propel venous blood from the periphery to the lungs and heart. Damage to these valves causes a long column of blood to produce enough hydrostatic pressure on the wall of the vein so small leaks occur. The lower legs swell and brownish blood pigment is deposited in the skin from degradation of hemoglobin. A dermatitis often occurs, and skin ulcers are common.
Dyshidrotic eczema (pompholyx) is a common but poorly understood condition in which very itchy small blisters occur on the lateral surface of the fingers, toes, hands, and feet. Many patients note exacerbations during periods of high stress (for example, finals week).
In order to make an accurate diagnosis of eczema, it is important for your physician to take a complete history and examine all of the areas of skin that are affected. Occasionally, certain laboratory tests can be helpful in distinguishing various types of eczema. A pathologist may need to examine skin scrapings and even a small piece of biopsied skin.
Once the diagnosis of atopic eczema is established, there are certain well-established approaches to treating this condition. One of the most important is to keep the skin well moisturized. There are many inexpensive approaches to maintaining the moisture content of the skin. Once the skin is wet, a thin layer of a cream or ointment is applied to prevent the moisture from evaporating. Judicious use of such substances (emollients) can be very effective in limiting flares of atopic eczema.
Corticosteroid creams are very effective at controlling the inflammatory component of atopic eczema. The thickened, itchy, weepy lesions respond well to the applications of such creams. In addition, oral antihistamines are effective in suppressing the itching sensation as well as acting as a sleep aid during flares.
Newer drugs have become available for the treatment of atopic eczema; they claim to be devoid of the side effects of topical steroids. These newer medications inhibit the immune response by inhibiting calcineurin, an enzyme necessary for a normal inflammatory response. Though they are quite effective, they are also quite expensive and seem to lack potency when compared to the strongest topical steroids. Ultraviolet light exposure can effectively control eczema in certain patients because of its effect on inflammatory cells in the skin.
Applying a good moisturizer to damp skin is the most effective method for limiting flares of atopic eczema. Try the measures listed on this and the following slide to control and help prevent outbreaks of eczema.
Since the condition is inherited, it would be very difficult to prevent its development entirely. Living in a warm, humid environment seems to limit flares of atopic dermatitis. Sleeping with a humidifier in the bedroom can be of some help. In some patients, adding chlorine bleach to bathwater can be quite helpful (1/2 cup of bleach to a bathtub of warm water). It is important to rinse off before applying an emollient.
IMAGES PROVIDED BY:
2005-2018 WebMD, LLC. All rights reserved.
Originally posted here:
Eczema (Atopic Dermatitis) Causes, Symptoms, Treatment
- Atopic dermatitis (eczema) - Symptoms and causes - Mayo Clinic - June 18th, 2018
- Dermatitis - Wikipedia - June 18th, 2018
- Eczema Symptoms & Causes | National Eczema Association - June 18th, 2018
- Eczema Types, Treatment, Home Remedies & Symptoms - June 18th, 2018
- Eczema: Definition, Causes, Treatments, and Pictures - June 18th, 2018
- Our Miracle Treatment for Eczema - The Hill Hangout - June 17th, 2018
- 13 Good Foods for Eczema Sufferers - Top Eczema Treatments - June 16th, 2018
- Eczema on face: Best creams and what to avoid - June 16th, 2018
- Home Remedies for Eczema - Treatment & Cure - Natural ... - June 9th, 2018
- Atopic dermatitis | American Academy of Dermatology - June 9th, 2018
- Thinking Moms Guide to Red Flags Eczema - June 9th, 2018
- Childhood Eczema How To Treat Eczema In Children - June 9th, 2018
- DIY Homemade Eczema Cream - Kula Mama - June 9th, 2018
- Eczema - KidsHealth - May 30th, 2018
- Dyshidrotic eczema | American Academy of Dermatology - May 30th, 2018
- Eczema (Atopic Dermatitis) | AAFA.org - May 30th, 2018
- What is eczema? | American Academy of Dermatology - May 30th, 2018
- Dermatitis - Symptoms and causes - Mayo Clinic - May 30th, 2018
- Vitamin D and eczema - May 30th, 2018
- Eczema Causes What Causes Eczema? - May 21st, 2018
- Eczema On Face Facial Eczema Treatment - May 21st, 2018
- Eczema: The Autoimmune Disease Everyone Seems To Be ... - May 21st, 2018
- Eczema Treatment, Home Remedies, and Causes - May 16th, 2018
- 10 Home Remedies for Eczema - eczema.net - May 11th, 2018
- Eczema Overview, Symptoms and Treatment - Health.com - May 3rd, 2018
- Eczema Healing with Natural Remedies - April 22nd, 2018
- What is Eczema? | NEOSPORIN - April 12th, 2018
- Atopic dermatitis (eczema) - Mayo Clinic - April 12th, 2018
- Eczema Guide: Causes, Symptoms and Treatment Options - April 12th, 2018
- My Struggle With Eye Eczema & My Miracle Cream. | Lux Life ... - April 7th, 2018
- Atopic dermatitis (eczema) - Diagnosis and treatment ... - March 31st, 2018
- Eczema Treatment, Home Remedies, and Causes - eMedicineHealth - March 21st, 2018
- Eczema | EVA Homoeopathy - March 7th, 2018
- Eczema - Canadian Dermatology Association - March 6th, 2018
- Atopic dermatitis - Wikipedia - March 6th, 2018
- Eczema & Dermatitis - Dr. Adrian Morris | Allergy Clinic - March 5th, 2018
- Atopic dermatitis (eczema) Symptoms - Mayo Clinic - February 5th, 2018
- Atopic dermatitis | DermNet New Zealand - February 3rd, 2018
- Eczema - Atopic Dermatitis | Eczema Treatment & Symptoms - January 28th, 2018
- Eczema | University of Maryland Medical Center - December 25th, 2017
- Eczema Information from Drugs.com - December 20th, 2017
- About Eczema : National Eczema Society - December 18th, 2017
- eczema.net - December 13th, 2017
- Topical Steroids : National Eczema Society - December 10th, 2017
- Atopic Dermatitis & Eczema - American Academy of Dermatology - December 3rd, 2017
- List of Eczema Medications (162 Compared) - Drugs.com - December 1st, 2017
- eczema in children - ACAAI Public Website - December 1st, 2017
- How To Prevent Eczema Flare-Ups In Winter | Women's Health - December 1st, 2017
- Eczema Facts Eczema Association of Australasia Inc - December 1st, 2017
- 3 Natural Remedies for Eczema - verywell.com - December 1st, 2017
- Eczema - Medical Disability Guidelines - December 1st, 2017
- How to Heal Eczema Naturally Through Diet - December 1st, 2017
- Eczema - British Skin Foundation - December 1st, 2017
- 10 Home Remedies for Eczema - Health - December 1st, 2017
- Eczema | Christiane Northrup, M.D. - December 1st, 2017
- DYSHIDROTIC ECZEMA - Eczema Treatment - December 1st, 2017
- Vitamin D Council | Vitamin D and eczema - December 1st, 2017
- eczema, itchy skin - allergy - December 1st, 2017
- Dermatitis (eczema). DermNet NZ - DermNet New Zealand - December 1st, 2017
- AbbVie's positive eczema study drags down Regeneron's shares - Reuters - September 7th, 2017
- AbbVie shares rally on positive eczema study, competitor Regeneron drops - Investing.com - September 7th, 2017
- New AstraZeneca, Amgen Biotech Drug Offers Broad Asthma Relief - New York Times - September 6th, 2017
- Dealing with eczema - Metro - September 4th, 2017
- SKIN HEALTH: Skin condition research | Post Life ... - The Fort Campbell Courier - September 1st, 2017
- SkinSmart Antimicrobial debuts with eczema and wound care ... - Drug Store News - August 31st, 2017
- Daniel Boey On His Own Eczema: Let's Show The World We Can Lead Fabulous Lives! - Weekender Singapore - August 28th, 2017
- When eczema gets you banned from driving a rideshare - Malay Mail Online - August 23rd, 2017
- Doctor: Eczema medications for children could have long-term side effects - WTSP 10 News - August 20th, 2017
- Fend off Psoriasis and Eczema with Simple, Inexpensive ... - August 20th, 2017
- Tell me about levitra - Viagra vs levitra user reviews - The Santa Clara - August 19th, 2017
- Sydney boy with eczema treated with 'miracle' cream - Gears Of Biz - August 19th, 2017
- Eczema cure? Doing THIS at the gym could treat the debilitating skin condition - Express.co.uk - August 17th, 2017
- 5 All-Natural Remedies To Treat Eczema Without The Doctor - The Alternative Daily (blog) - August 14th, 2017
- Does Early Probiotic Supplementation Reduce Eczema, Asthma Development? - Monthly Prescribing Reference (registration) - August 12th, 2017
- Dermira Commits $135M for Global Rights to Roche Eczema Drug - Xconomy - August 12th, 2017
- 3 Natural Ways To Manage Eczema - Reports Healthcare - August 8th, 2017
- Taking too many antibiotics to treat eczema may worsen your condition - Miami Herald - August 6th, 2017
- Eczema and psoriasis treatment: THIS therapy could reduce the need for creams and tablets - Express.co.uk - August 6th, 2017
- How to get rid of eczema, beat the itch and scratch cycle - The Standard - August 4th, 2017
- Eczema can be worse for adults - Health24 - August 1st, 2017