Dermatologist Stratford - Eczema is a kind of dermatitis or inflammation of the outer layer of the skin called the epidermis. The term is derived from the Greek language and means "to boil over." In England, around 1 in 9 individuals or a projected 5,773,700 individuals have been diagnosed with eczema at some point in their lives. In some languages, the words dermatitis and eczema are synonymous and often the two conditions are classified together. In other languages, the term eczema refers to a chronic condition and dermatitis implies an acute one.
The word broadly covers different persistent skin conditions like: recurring skin dryness and rashes that is associated with at least one of the following indications of dryness and itching, crusting, flaking, oozing, bleeding, skin oedema or swelling and blistering. Every so often, temporary skin discoloration may result. As well, scratching open a lesion that is in the healing process may enlarge the rash and could result in potential scarring.
Describing eczema can be confusing. It may be described by specific appearance, by location or by possible cause. Many sources even utilize the words atopic dermatitis that is the most common type of eczema and the term eczema interchangeably with can add to the confusion.
These classifications are ordered by the frequency of incidence.
Atopic eczema, that is also referred to as atopic dermatitis, infantile eczema or flexural eczema, is an allergic disease thought to have a genetic factor. Atopic eczema is prominent in families with people who also have asthma. There tends to be an itchy rash which develops on the scalp and head, the inside of elbows, behind the knees and on the buttocks. This particular kind of eczema is somewhat common in developed nations. It can be hard to differentiate between irritant contact dermatitis.
Contact dermatitis falls into two categories: allergic and irritant. Irritant dermatitis can result directly from a reaction to anything particular such as a detergent like sodium lauryl sulphate. Allergic dermatitis can occur as a result of a delayed reaction to some allergen like for instance nickel or poison ivy. Wet cement is an example of a substance that acts as both an irritant and an allergen. Phototoxic dermatitis could happen with other substances after sunlight exposure. Approximately three quarters of contact eczema cases are the irritant type. This is the most common occupational skin disease. If traces of the offending substance can be removed from one's environment and avoided, contact eczema can be curable.
There is a type of eczema that becomes worse during dry winter weather and commonly affects the limbs and the trunk. It is called craquele eczema or xerotic eczema, winter itch, asteatotic eczema, craquelatum eczema or pruritus hiemalis. The tender, itchy skin resembles a dry and cracked river bed. This condition is very popular amongst older patients. A connected disorder is Ichthyosis.
Cradle cap in babies is officially known as Seborrheic or Seborrhoeic dermatitis. This is a condition which is usually classified as a kind of eczema that is related closely to dandruff. It causes a dry or greasy flaking of the scalp and could even affect the eyebrows, face and occasionally the trunk. This is considered a harmless condition except in severe conditions of cradle cap. In newborns, it presents as a thick, yellow, crusty scalp rash which is known as cradle cap. This condition has been connected to a lack of biotin and is usually curable.
Less Common Types of Eczema
One more type of eczema is referred to as Dyshidrosis or pompholyx eczema, dyshidrotic eczema, housewife's eczema or vesicular palmoplantar dermatitis. This form is known for only showing up on the palms, toes and sides of toes and fingers. It presents with tiny opaque bumps referred to as vesicles, thickening skin and cracks are accompanied by itching which becomes worse at nighttime. This is a common kind of hand eczema and it becomes worse in warm weather.
Venous e., Discoid e., Duhring's Disease or DermaDermatitisetiformis, Autoeczematization and Neurodermatitis are other less common types of eczema, which are overlaid by viral infections. Some eczemas result from underlying disease, as in lymphoma for example. There are various other rare eczematous disorders that exist in addition to these too.
Some attribute eczema to the hygiene hypothesis. This theory postulates that the cause of eczema, asthma and other allergic diseases is because of a very clean surrounding. This particular theory is supported by epidemiologic studies for asthma that states that during development it is essential to be exposed to bacteria and immune system modulators and thus, missing out on this exposure increases the risk for asthma and allergy.
One more theory suggested is that eczema is an allergic reaction to the excrement from house dust mites. Though 5% of individuals show antibodies to the mites, the hypothesis awaits further justification.
Typically, the diagnosis of eczema is based mainly on physical examination and history, however, in several cases, a skin biopsy can prove useful.
People who have eczema should not be given the smallpox vaccination due to the chance of developing eczema vaccinatum. This is a possibly sever and sometimes fatal complication.
As there is no common treatment for eczema, general treatments include the control of symptoms by relieving the itching and reducing the inflammation. Medications that are available comprise corticosteroids, hydrocortisone, injectable or oral corticosteroids. These come with several possible side effects, most commonly thinning the skin, even though there is ongoing study in this particular field. Usually, these steroids are to be used very carefully and a little goes a long way.
Due to potential chance of lymph node cancers and skin cancers, a public health advisory has been issued by the FDA on using immunomodulators. Different professional medical groups disagree with the FDA findings.
Some severe cases of eczema are treated with immunosuppressant drugs. These are sometimes prescribed and could yield dramatic improvements to the patient's eczema but because they dampen the immune system, they could have major side effects. To be able to be on this kind of therapy, patients be carefully monitored by a physician and go through regular blood tests.
Using antihistamine and other anti-itch drugs can help in the treatment of the itching element of eczema. By initiating a sedative effect, these work to reduce damage and irritation to the skin. Various popular sedating antihistamines comprise Benadryl or Phenergan. Moisturizers are likewise applied to the skin to help the soothing and healing purpose. Capsaicin applied to the skin acts as a counter irritant and hydrocortisone cream is likewise used, although, numerous health food stores provide some preparations with essential fatty acids and tea tree oil as an alternative.
By applying cool water via swimming, a wet washcloth or a bath, many patients have found quick relief. One more proven soothing treatment is to apply an icepack wrapped in a soft cloth or even using air blowing from an air conditioning vent.
Click to Download the pdf