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Eczema

Category(s): Dermatology

Overview

Synonyms : Atopic dermatitis

Eczema is a skin disease that can last for a most of a person's life. It makes skin red, irritated and skin may start to fall off. The person may get a rash and skin may ooze fluids. Eczema is commonly seen on the backs of knees and also during the winter.

If a person has eczema, the person's skin turn a lighter color in the area and itching may occur.

There are three types of eczema:

Some foods or medicines can trigger eczema. Eczema is also known as dermatitis. Babies generally have eczema on the face, particularly in the chin and cheeks. It can also occur on the chest, scalp, back, and outer legs and arms. Adults and children likely to have eczema on the wrists, neck and ankles, and in areas that bend, like the inner knee and elbow.

Symptoms

Atopic dermatitis symptoms vary widely from one person to other and include:

  • Atopic dermatitis most often begins before 5 years of age and may persist into adolescence and adulthood. For some people, it flares periodically and then clears up for a time, even for several years.
  • Small, raised bumps, which may leak fluid and crust over when scratched.
  • Red to brownish-gray patches particularly on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees, and, in infants, the face and scalp.
  • Itching, which may be severe, especially at night.
  • Dry skin, which can result from long, hot baths or showers.
  • Raw, sensitive, swollen skin from scratching.
  • Thickened, cracked, dry, scaly skin.

Causes

The exact cause of atopic dermatitis is not known. Healthy skin helps to retain moisture and protects from irritants, bacteria and allergens.

Eczema is combination of factors:

  • A gene variation that affects the skin's barrier function.
  • Immune system dysfunction.
  • Irritable, dry skin, which reduces the skin's ability to be an effective skin barrier.
  • Bacteria, such as Staphylococcus aureus, on the skin that form a film which blocks sweat glands.
  • Environmental conditions.

Diagnosis

Diagnosis of eczema include:

No lab test is required to identify dermatitis.

Physical exam and history: Diagnosis is done by examining the skin and reviewing the medical history of the patient.

Patch test: Doctor may use patch testing or other tests to rule out other skin conditions or identify conditions that accompany eczema.
In the patch test, small amounts of different substances are applied to patient’s skin under an adhesive covering. After 2-3 days, a doctor examines the skin to see if a patient has a reaction to any of the substances. 

Skin biopsy: During biopsy a small amount of skin is removed for examination under a microscope. During the procedure, the patient will be given a local anesthetic to numb the area; if it is deeper inside the body, a general anesthetic (medication to block the awareness of pain) will be used. Then a pathologist examine the sample removed during the biopsy. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating tissues, cells, and organs to diagnose disease. It can be performed to rule out other skin conditions.

Treatment

Doctor may suggest the following drugs and treatments:

Medications:

Creams to control itching and inflammation: Corticosteroid cream or ointment.

Creams to repair the skin: Calcineurin inhibitors e.g. pimecrolimus and tacrolimus are applied to the skin to control itching, maintain normal skin and reduce flares of atopic dermatitis.

Drugs to fight infection: Antibiotics

Oral anti-itch drugs: Oral antihistamines e.g. diphenhydramine.

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