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What is Eczema?
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Eczema, or dermatitis are skin
conditions that can affect all age groups. In the U.K up to one fifth of
all children of school age have eczema, along with about one in twelve
of adults. The severity of the disease can vary. In mild forms the skin
is dry, hot and itchy, whilst in more severe forms the skin can become
broken, raw and bleeding. Although it can sometimes look unpleasant,
eczema is not contagious. With treatment the inflammation of eczema can
be reduced, though the skin will always be sensitive to flare-ups and
need extra care.
There are several different types
of eczema, which look similar but have very different causes and
treatments. It is very important to see a doctor, who may refer you to a
dermatologist for further diagnosis and treatment.
Causes of eczema are many Atopic
eczema is thought to be hereditary being genetically linked. It is
thought people with atopic eczema are sensitive to allergens in the
environment. In atopy there is an excessive reaction by the immune
system producing inflamed, irritated and sore skin. Associated atopic
conditions include asthma and hayfever. Other types of eczema are caused
by irritants such as chemicals and detergents, nickel, and yeast
growths. The causes of some types of eczema are still unexplained but
links with environmental factors and stress are being looked at.
Different
types of Eczema
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Allergic contact eczema
This develops when the
body’s immune system reacts against a substance in contact with the
skin. The allergic reaction often develops over a period of time through
repeated contact with the substance. For example, an allergic reaction
may occur to nickel, which is often found in earrings, belt buckles and
jeans buttons. Reactions can also occur after contact with other
substances such as perfumes and rubber. In order to prevent repeated
reactions it is best to prevent contact with anything that you know
causes a rash.
Atopic eczema
Atopic eczema is the commonest form of eczema and is closely linked with
asthma and hayfever. It can affect both children and adults, usually
running in families. One of the most common symptoms of atopic eczema is
its itchiness (or pruritis), which can be almost unbearable. Other
symptoms include overall dryness of the skin, redness and inflammation.
Constant scratching can also cause the skin to split, leaving it prone
to infection. In infected eczema the skin may crack and weep (‘wet’
eczema). Treatments include emollients to maintain skin hydration and
steroids to reduce inflammation.
Irritant contact dermatitis
This is a type of eczema
caused by frequent contact with everyday substances, such as detergents
and chemicals, which are irritating to the skin. It most commonly occurs
on the hands of adults and can be prevented by avoiding the irritants
and keeping the skin moisturised.
Infantile seborrhoeic eczema
A common condition affecting
babies under one year old, the exact cause of which is unknown. Also
referred to as cradle cap, it usually starts on the scalp or the nappy
area and quickly spreads. Although this type of eczema looks unpleasant,
it is not sore or itchy and does not cause the baby to feel
uncomfortable or unwell. Normally this type of eczema will clear in just
a few months, though the use of moisturising creams and bath oils can
help to speed this along.
Adult seborrhoeic eczema
Characteristically affects
adults between the ages of 20 and 40. It is usually seen on the scalp as
mild dandruff, but can spread to the face, ears and chest. The skin
becomes red, inflamed and starts to flake. The condition is believed to
be caused by a yeast growth. If the condition becomes infected,
treatment with an anti-fungal cream may be necessary.
Discoid eczema
Is usually found in adults
and appears suddenly as a few coin shaped areas of red skin, normally on
the trunk or lower legs. They become itchy and can weep fluid. Usually
discoid eczema is treated with emollients (and steroid creams if
necessary).
Varicose eczema
Varicose eczema affects the
lower legs of those in their middle to late years, being caused by poor
circulation. Commonly the skin around the ankles is affected, becoming
speckled, itchy and inflamed. Treatment is with emollients and steroid
creams. If left untreated, the skin can break down, resulting in an
ulcer.
Dyshidrotic Eczema
Dyshidrotic eczema is a chronic recurrent dermatitis that affects palms
and soles, as well as fingers. It's characterized by the initial
appearance of vesicles, which evolve later on with scaling in the form
of necklace. If the process chronifies, fissures or cracks appear and
often bacterial infection. This disease appears equally in both sexes,
and especially in people less than 40 years old.
Nearly half of the patients have a history of atopy, and frequently they
have a personal background of atopic dermatitis, allergic rhynitis or
asthmatic bronchitis. Sometimes, outbreaks appear after the changes of
season, particularly in spring and autumn. Other patients are allergic
to metals (nickel).
When they eat foods that contain nickel they suffer outbreaks of
dyshidrotic eczema on hands. Sometimes, dyshidrotic eczema is produced
on the hands by a fungus infection on the feet. Smoking increases
dyshidrotic eczema. Psychic stress is an important factor. Many of these
patients sweat very much.
Treatment
Dyshidrotic eczema is a friendly illness, although
cure doesn't exist, it can be controlled. One of the most effective
treatments consists of applying cortisone creams on the affected areas.
This cream should be applied twice a day at least for one week. When
lesions disappear, application may be tapered at once every other day
for another week, and then to every two days for other two weeks. If
lesions reappear it is necessary to start the treatment again.
Other treatment consists of applying fungicide creams on the feet
because, although dyshidrotic eczema is not produced by fungus, it is
known that fungus infection on the feet triggers dyshidrotic eczema on
the hands. The cream should be applied twice a day for 4 weeks. You are
advised to dry the feet after every shower and to use regularly an
antiperspirant product. When big vesicles exist, they should be
punctured with a needle to take out their liquid content, but without
eliminating their cover. When a metal allergy (nickel) exists, an exempt
diet of nickel is recommended. In cases of dyshidrotic eczema with
continuous relapses, treatment with ultraviolet rays (Puva) 3-4 times a
week for 4-6 weeks is advisable. This treatment is the best one for
dyshidrotic eczema, even in the vesicular phase. Sometimes, oral
antihistaminics and antibiotics may be also useful. Lower Nickel Diet
Advised Food: meat, chicken, fish (except herring), eggs, milk, yogurt,
butter, margarine, cheese, a medium size potato every day, small amount
of cauliflower, cabbage, carrots, cucumber or lettuce, refined rice,
flour (not in grain), fresh fruit (not pears), jam and marmalade,
coffee, wine and beer.
Inadvisable Food: canned food, and acid cooked in a metal pan, herring
and oyster, asparagus, beans, kidney bean, mushrooms, onion, corn,
spinach, tomatoes, pees, fresh or cooked pears, ruibarb, tea, cacao,
chocolate, baking powder and cereals
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