Eczema

What is Eczema?

Atopic dermatitis, commonly referred to as eczema, is a chronic, very itchy red rash.  It is the most common chronic skin disease seen in young children, and will frequently precede the development of allergies and/or asthma.  Although it is most common in young children, it can affect patients of any age. 

Eczema most often presents before the age of five, and is characterized mainly by intense itching.  While the severity of eczema often decreases with age, patients will often continue to have flares even into adulthood. 

Features:

  • Intense itching, or pruritis
  • Can come and go
  • Has a typical distribution over the body
  1. Infants and small children: involves mainly the face, scalp and elbows and knees, although other areas can be affected; the diaper area is usually spared.
  2. Older patients: the flexural surfaces of the extremities are most often affected, namely the inner creases of the elbows and knees, but can be present anywhere.

Complications:

  • Infections: patients with eczema are at an increased risk of skin infections as a result of itching, which leads to trauma from scratching.  These infections are most commonly bacterial, but can be viral or fungal.
  • Hyperpigmentation: this results from chronic lesions that form over time after being scratched and /or infected repeatedly.  The skin in these areas appears darker and is often scalier and thicker.
  • Psychological factors: the intense itching associated with eczema can often lead to sleep disturbance and difficulty concentrating, and can lead to anxiety and emotional stress.  

Triggers

  • Foods: specifically those that have been positive with skin/blood testing during allergy evaluation.  Most commonly involved are milk, egg, soy, wheat, fish, and tree nuts.
  • Inhaled allergens: especially house dust mites, can trigger eczema flares.
  • Bacteria: bacteria living on the skin, specifically S. aureus can increase the body’s immune response and cause flares.  
  • Irritants: these can include cleansers, detergents, soaps and other chemicals, especially those containing scents and dyes, as well as abrasive clothing and extremes in temperature.  

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