ECZEMA

Eczema or atopic dermatitis is a skin condition caused by inflammation of the skin making it red and itchy. Atopic dermatitis is long lasting (chronic) and tends to flare periodically and then subside. It may be accompanied by asthma or hay fever.

Different types of eczema:

Atopic Dermatitis

Atopic dermatitis is the most common form of eczema. It often affects people who also have asthma or hay fever. Characteristically, rashes occur on the cheeks, neck, elbow and knee creases, and ankles.

Contact Dermatitis

There are two types of contact dermatitis:

  • Irritant contact dermatitis. This occurs when the skin is repeatedly exposed to toxic substances.
  • Allergic contact dermatitis. After repeated exposures to the same substance, the body’s immune recognition system becomes activated at the site of the next exposure and produces eczema.

Dyshidrotic Dermatitis

The first symptom may be severe itching. Blisters may then appear, which give way a few weeks later to scaly patches. Sometimes deep cracks can appear on the hands or fingers.  This type of eczema may become chronic and painful.

Nummular Dermatitis

This is a nonspecific term for coin-shaped plaques of scaling skin most often on the lower legs of older individuals.

Neurodermatitis

People with this type of eczema develop skin irritation in spots that they frequently scratch out of habit.

Seborrheic Dermatitis

Seborrheic dermatitis causes skin to fall off in flakes. The condition may be due to an overgrowth of a type of yeast that normally lives in these areas, as well as an overgrowth and rapid shedding of cells on the scalp. It may be especially hard to treat in people whose immune systems aren’t working properly, including people with AIDS .

Stasis Dermatitis

Stasis dermatitis can arise quickly, causing weeping and crusting of the skin. Over time, this type of eczema can cause the skin to develop brown stains.

Eczema comes in many forms. But the different types of eczema tend to cause these symptoms:

  • Itching . The itching can be intense. The damage to the skin during eczema is often due to scratching.
  • Scaling. The surface of the skin can flake off, giving the skin a rough, scaly appearance.
  • Redness. The affected skin may bleed and appear blotchy.
  • Fluid-filled blisters. These can ooze and form crusts.
  • Cracking. Severely affected skin may develop painful, deep cracks, also called fissures.

Depending on the cause, eczema may flare up and cause severe symptoms. But it can also become a chronic problem with less intense symptoms.

DIAGNOSIS

The best way to diagnose eczema is for a doctor to take thorough medical and family histories. The doctor can sometimes tell by looking at the rash whether or not it is eczema. It is important to rule out curable conditions caused by infectious organisms. Occasionally, a sample of skin (biopsy) may be sent for examination in a laboratory.

Although there is no test for eczema, allergy testing can help pinpoint any allergic triggers. Other common triggers include irritants, heat, or emotions.

 

RECOMMENDED MEDICATIONS

It is important to recognize the condition early so you can start treatment. If regular moisturizing and other self-care steps don’t help, your doctor may suggest the following treatments and drugs:

Medications

  • Corticosteroid cream. Your doctor may prescribe a corticosteroid cream or ointment.
  • Calcineurin inhibitors. Drugs called calcineurin inhibitors — such as tacrolimus (Protopic) and pimecrolimus (Elidel) — affect your immune system. Applied to the skin, they help maintain normal skin, control itching and reduce flares of atopic dermatitis.
  • Antibiotics. You may need antibiotics if you have a bacterial skin infection or an open sore or cracked skin caused by scratching.
  • Oral anti-itch drugs. If itching is severe, oral antihistamines may help. Diphenhydramine (Benadryl, others) can make you sleepy and may be especially helpful at bedtime.
  • Oral corticosteroid. For more-severe cases, your doctor may prescribe oral corticosteroids — such as prednisone — or an injected corticosteroid.

Therapies

  • Wet dressings. An effective, intensive treatment for severe atopic dermatitis involves wrapping the affected area with topical corticosteroids and wet bandages.
  • Light therapy. The simplest form of light therapy (phototherapy) involves exposing your skin to controlled amounts of natural sunlight. Other forms use artificial ultraviolet A (UVA) and narrow band UVB either alone or with medications.
  • Treatment for stress. Counseling may help children and young adults who are extremely embarrassed or frustrated by their skin condition.
  • Relaxation, behavior modification or biofeedback. These approaches may help you with habitual scratching.

Infantile eczema

Treatment for infantile eczema includes:

  • Identifying and avoiding skin irritations
  • Avoiding extreme temperatures
  • Lubricating your baby’s skin with bath oils, lotions, creams or ointments

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