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Eczema

Eczema is a well-known and common condition that affects the skin of some individuals. The interesting thing about this condition, is that it affects people differently.

It can be generally called Eczema but can also be referred to as Atopic Dermatitis.

This condition is when the outer layer of the skin (epidermis) becomes significantly inflamed. This can cause some skin swelling, dryness, itching, and a rash like appearance. Often though, Eczema is used widely for several skin conditions that may or may not apply to this skin condition.

The difficulty aspect of this condition is that it affects each person differently. Eczema symptoms can be different depending on skin location.

Symptoms

–  Skin dryness
–  Redness
–  Swelling of skin
–  Itching
–  Crusting of skin
–  Cracking of skin
–  Patches of irritation
–  Flaking
–  Blistering of skin
–  Skin bleeding
–  Clear discharge (Oozing)

Classification

This largely depends on the cause or underlying diseases associated with this condition. Classification also depends on location of symptoms.

Common Forms

1.)  Actopic Eczema

.   This is often caused by an unknown or known allergy reaction.
.   Can be hereditary in many cases, but not all.
.   Often can be seen in patients who exhibit Asthma or who have family members who have asthma.
.   Rash is often found on scalp, neck, elbows, behind knees, and buttocks.

2.)  Contact Dermatitis

.  Two types: Allergic and Irritant

.   Allergic: A delayed reaction to an allergen  (poison ivy or nickel)
.   Irritant: Direct reaction to a cause agent

3.)  Seborrheic Dermatitis

.   Is a long term skin disorder where red, scaly, greasy, itching, and inflamed skin can be seen.
.   Cause is unclear but genetic factors, stress, and environmental factors may be involved.
.   Treatment can be antifungal and anti-inflammatory agents

4.)  Stasis Dermatitis

.   Changes that occur in the leg because of pooling of blood, edema, or other vascular causes
.   Insufficient venous return is the primary cause
.  Changes of the skin can mask as redness, infection, and inflammation.

Potential Causes

1.)  Environment

.   This includes a history of Asthma and other childhood allergic disease
.   Possible reaction to stress, cold, anxiety, dust, wool, or other irritant

2.)  Malnutrition

.   Has been seen in those with lack of Zinc or Biotin

3.)  Genetic

.  There have been an number of genes studied to see if there is a connection.
.  Recently three genes have been tagged as potential risks:  OVOL1, ACTL9, and IL4-KIF3A

Prevention

1.)  Some studies show breastfeeding a child may decrease a future risk for the child

2.)  Healthy Diet – 1st: Evaluate for possible food allergy.  2nd: A low inflammation diet

3.) Fatty Acids – Add Corn oil, Fish oil, Hemp seed oil – some studies show that this decreases the risk

Treatment

1.)  Lifestyle

.   Bathing once or more a day is recommended
.   Soaps should be avoided
.   The American Academy of Dermatology suggests – a controlled amount of bleach in a diluted bath may help with Atopic Dermatitis
.  Wear clothes that reduce itching, scratching, and peeling
.  House dust mite reduction

2.)  Moisturizers

.   Some emollients may reduce eczema severity
.   In children – oil-based formulations by be better than water based formulations.
.   Products with perfumes or peanuts should be avoided
.   Occlusive dressings may provide some benefit – especially if used at night.
.   Exam and test Detergents to see what works and what doesn’t

3.)  Medications

.  Corticosteroids

–   Hydrocortisone, Clobetasol, and other steroids can be used

.   Antihistamines

–  These medications may or may not help with relief from dermatitis but they might help itching
–  Benadryl (diphenhydramine) can be helpful for those who have trouble sleeping due to itching
–  Loratadine, Allegra (Fexofenadine), Zyrtec have varied benefits – depending on the person.

.   Immunosuppressants

–  Primecrolimus and Tacrolimus – used for a short period of time
–  Can be somewhat effective
–  Often used in severe cases that don’t resolve or respond to other treatments

Light Therapy

–  Narrowband UVB has some evidence of improvement in some patients