Eczema

Short Description of Eczema 

Eczema is a skin condition also known as atopic dermatitis. It is a common issue of the skin that is characterized by itchy and inflamed patches. 

Symptoms 

Eczema is itchy, dry, rough, flakey, inflamed, and irritated skin. It can flare up, subside, and then flare up again.

Eczema can occur anywhere but usually affects the arms, inner elbows, backs of the knees, or head (particularly the cheeks and the scalp). It’s not contagious, and, in some cases, becomes less severe with age.

Other symptoms include:

• intense itching
• red or brownish-gray patches
• small, raised bumps that ooze fluid when scratched 
• crusty patches of dried yellowish ooze, which can signal infection
• thickened, scaly skin

Scratching further irritates and inflames the skin. This can cause infections that must be treated with antibiotics.

About Eczema 

Eczema affects over 31.6 million people in the United States. Also known as atopic dermatitis it is a collection of conditions that affect the immune system. Certain foods like nuts and dairy products can trigger symptoms. There are also environmental triggers that include smoke, pollen, soaps and fragrances. The condition is not contagious. Approximately a quarter of US children have the condition including 10% of African-Americans, 13% of Asian Americans and Pacific Islander, 13% of Native American and 11% of Caucasians.  Some people are able to outgrow the condition while others will continue to have it throughout adulthood. 

Etiology of Eczema

The cause of the disease is not fully understood yet.  However, it is believed that it is triggered by an overactive immune response that responds aggressively when challenged with irritants.  In patients with eczema, the immune system loses its ability to know the difference between the two, which cause the inflammation. When a patient has an eczema flare-up there are one or more symptoms that appear on the skin.  Here are some common triggers of the condition:

• chemicals found in cleaners and detergents that dry out the skin is a cause
• rough scratchy material, like wool
• synthetic fabrics
• raised body temperature
• sweating
• temperature changes
• sudden drop in humidity
• stress
• food allergies
• animal dander
• upper respiratory infections

There are several risk factors that predispose people for developing eczema. It is more common in children who have asthma or hay fever, or adults that develop the conditions later, prior to age 30.  People with family members who have eczema are also at higher risk of developing it. 

Diagnosis of Eczema 

There is no specific test to diagnose eczema. If the doctor has seen the condition before, he may be able to recognize it via the symptoms that appear on the skin.  A patch test can help determine allergens that trigger the symptoms, like skin allergies associated with contact dermatitis (a kind of eczema). When a patch test is done, the allergen is applied to a patch and then placed on the skin. If you are allergic, the skin will become inflamed and irritated indicating a positive test. 

Types of Eczema 

Atopic Dermatitis – This is the most common type and usually begins in childhood but often gets milder or even goes away when the patient reaches adulthood. Atopic dermatitis forms an atopic triad that consists of asthma, hay fever and atopic dermatitis. Many people with atopic dermatitis have all three conditions.  Symptoms include: rash that forms in the creases of the elbows or knees, skin in areas where the rash appears will turn lighter or darker and or thicker, small bumps may appear to leak fluid if they are scratched, babies get the rash on their scalp and cheeks and skin can get infected if scratched.  Atopic dermatitis happens when the skin’s natural barrier against the elements is compromised. This makes your skin less able to safeguard you from irritants and allergens. Atopic dermatitis is due to a combination of factors such as genes, dry skin, immune system weakness or triggers in the environment. 

Contact Dermatitis – This is characterized by the presence of red, irritated skin that is caused by a reaction to substances you touch. It comes in two variants: allergic contact dermatitis an immune system reaction to an irritant such as latex or metal. Irritant contact dermatitis happens when a chemical or other substance irritates the skin.  Symptoms include: itchy skin that turns red, burns and stings, presence of itchy bumps called hives may pop up, fluid-filled blisters that can form and ooze, over time the skin can feel scaly or leathery. 

Contact dermatitis happens when the patient touches a substance that irritates the skin or causes an allergic reaction. The most common causes include:

• detergents
• bleach
• jewelry
• latex
• nickel
• paint
• poison ivy and other poisonous plants
• skin care products, including makeup
• soaps and perfumes
• solvents
• tobacco smoke

Dyshidrotic Eczema – This refers to an irritation of the skin on the palms of the hands and soles of the feet. It is characterized by the presence of blisters. 

Discoid Eczema – Also known as nummular eczema and presents with circular patches of crusted, scaly and itchy skin. 

Stasis Dermatitis – It is a skin irritation of the lower leg and is usually attributed to circulatory issues. 

While eczema is a common skin condition in children, most will outgrow it by the time they reach adolescence. The discomfort it causes varies in severity and present differently depending on the age of the person. In people with darker skin tones, the symptoms are harder to see. While there is no cure yet for eczema, the condition is treatable and preventable.