About eczema

What is eczema?

Eczema facts

  • Eczema is not a single disease but a reaction pattern of the skin produced by a number conditions.
  • Atopic dermatitis, a common causes of eczema, is more prevalent in those with asthma and hay fever.
  • Eczema appears as small blisters that can weep and ooze, or as crusted, thickened plaques of skin. It is almost always quite itchy.
  • It is important to distinguish the different kinds of eczema because effective treatments often differ.
  • If eczema is produced by skin exposure to a specific substance, it can be helpful to avoid it.
  • Keeping the skin healthy and moisturized can prevent many kinds of eczema.

What is eczema?

Rather than a specific condition, eczema is a group of unrelated diseases that have a similar appearance. When it is new eczema, the affected skin appears red and elevated with small blisters (vesicles) containing a clear fluid. When the blisters break, the affected skin will weep and ooze. In older eczema, chronic eczema, the blisters are less prominent and the skin is thickened, elevated, and scaling. Eczema almost always is very itchy.

Are there different types of eczema? 

There are at least 11 different types of skin conditions that produce eczema. In order to develop a rational treatment plan, it is important to distinguish them. This is often not easy.

  1. Atopic dermatitis: This condition has a genetic basis and is probably most commonly called eczema. Atopic dermatitis tends to begin early in life in those with a predisposition to inhalant allergies, but it probably does not have an allergic basis. Characteristically, rashes occur on the cheeks, neck, elbow and knee creases, and ankles. Rarely, a few those with atopic dermatitis can get an extensive herpes simplex infection called "eczema herpeticum."
  2. Irritant dermatitis: This occurs when the skin is repeatedly exposed to toxic substances.
  3. 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.
  4. Stasis dermatitis: It commonly occurs on the swollen lower legs of people who have poor circulation in the veins of the legs.
  5. Fungal infections: This can produce a pattern identical to many other types of eczema, but the fungus can be visualized with a scraping under the microscope or grown in culture.
  6. Scabies: It's caused by an infestation by the human itch mite and may produce a rash very similar to other forms of eczema.
  7. Pompholyx (dyshidrotic eczema): This is a common but poorly understood condition which classically affects the hands and occasionally the feet by producing an itchy rash composed of tiny blisters (vesicles) on the sides of the fingers or toes and palms or soles.
  8. Lichen simplex chronicus: It produces thickened plaques of skin commonly found on the shins and neck.
  9. Nummular eczema: This is a nonspecific term for coin-shaped plaques of scaling skin most often on the lower legs of older individuals.
  10. Xerotic (dry skin) eczema: When the skin becomes pathologically dry, it will crack and ooze.
  11. Seborrheic eczema: It produces a rash on the scalp, face, ears, and occasionally the mid-chest in adults. In infants, in can produce a weepy, oozy rash behind the ears and can be quite extensive, involving the entire body.

What are the symptoms for eczema?

Inflammation caused by atopic dermatitis can cover large areas of the body, such as the chest, or be limited to a few small locations.

Infantile eczema 

In infants, atopic dermatitis (infantile eczema) usually appears as red, Itchy patches that are associated with very dry skin.

Atopic dermatitis (eczema) signs and symptoms vary widely from person to person and include:

  • Dry skin
  • Itching, which may be severe, especially at night
  • Red to brownish-gray patches, especially 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
  • Small, raised bumps, which may leak fluid and crust over when scratched
  • Thickened, cracked, scaly skin
  • Raw, sensitive, Swollen skin from scratching

Atopic dermatitis most often begins before age 5 and may persist into adolescence and adulthood. For some people, it flares periodically and then clears up for a time, even for several years.

What are the causes for eczema?

Healthy skin helps retain moisture and protects you from bacteria, irritants and allergens. Eczema is related to a gene variation that affects the skin's ability to provide this protection. This allows your skin to be affected by environmental factors, irritants and allergens.

In some children, food allergies may play a role in causing eczema.

What are the treatments for eczema?

What is the treatment for eczema?

The treatment of acute eczema requires repeated cycles of application of dilute aqueous solutions followed by evaporation. This is most often conveniently performed by placing the affected body part in front of a fan after the compress. Once the acute weeping has diminished, then topical steroids (such as triamcinolone cream) application can be an effective treatment. In extensive disease, systemic steroids may need to be utilized either orally or by an injection (shot).

What are home remedies for eczema?

Mild eczema may respond to compresses composed of tepid water followed by room air evaporation. Chronic eczema can be improved by applying water followed by an emollient (moisturizing cream or lotion).

What are the risk factors for eczema?

The primary risk factor for atopic dermatitis is having a personal or family history of eczema, allergies, hay fever or asthma.

Is there a cure/medications for eczema?

Atopic dermatitis or eczema may last for years. To control it, you might need to try a variety of medications over the course of months or years. Additionally, even after successful therapy, signs and symptoms could come back (flare).

Early diagnosis of the illness is crucial in order to begin treatment. Your doctor might advise one or more of the following therapies if routine moisturizing and other self-care practices are ineffective:

  • Creams that reduce itching and aid in skin repair: A corticosteroid cream or ointment may be recommended by your doctor. After moisturizing, use it as instructed. Skin thinning is one of the negative effects of using this medication excessively.
  • Your immune system is impacted by other creams that contain calcineurin inhibitors, such as tacrolimus (Protopic) and pimecrolimus (Elidel). Older children and adults use them to help manage skin reactions. After moisturizing, use it as instructed. When using these items, stay out of direct sunlight.
  • Antibiotic cream: This may be recommended by your doctor if your skin has a bacterial infection, an open sore, or breaks. For a brief period of time, he or she might advise taking oral antibiotics to treat an infection.
  • Oral anti-inflammatory medications: In circumstances when the inflammation is more severe, your doctor may recommend oral corticosteroids, such as prednisone. While these medications are efficient, the possibility of major adverse effects prevents their long-term use.


Symptoms
Dry skin,Itchy skin,Red rashes,Bumps on the skin,Scaly, leathery patches of skin,Crusting skin,Swelling
Conditions
Rashes on the body,Thickening of the skin,Contact dermatitis,Dyshidrotic eczema,Neurodermatitis,Nummular eczema,Seborrheic dermatitis,Stasis dermatitis
Drugs
Hydrocortisone creams,Antihistamines,Azathioprine (Azasan),Methotrexate,Mycophenolate mofetil (CellCept),Phosphodiesterase inhibitors (Eucrisa ointment),Ruxolitinib (Opzelura cream),Upadacitinib (Rinvoq),Moisturizers,Calamine lotion

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