29/01/2014
Eczema
The term eczema is derived from the Greek, meaning "to boil out." The name is particularly apt since to ancient medical practitioners it may have appeared that the skin was "boiling." Today the usage is rather imprecise since it is frequently used to describe any sort of dermatitis (inflammatory skin condition). Not all dermatitis is eczematous. All eczematous dermatitis has a similar appearance. Acute lesions are composed of many small fluid-filled structures called vesicles that usually reside on red, swollen skin. When these vesicles break, fluid leaks out, causing characteristic weeping and oozing. When the fluid dries, it produces a thin crust. In older lesions, these vesicles may be harder to appreciate, but an examination of the tissue under the microscope will reveal their presence. Eczematous dermatitis has many causes. One of the most common is a condition called atopic dermatitis. Often those using the term eczema are referring to atopic dermatitis. Although atopy refers to a lifelong inherited (genetic) predisposition to inhalant allergies such as asthma and allergic rhinitis (hay fever), atopic dermatitis is not an allergic disease. Atopic patients are likely to have asthma, hay fever, and dermatitis. Atopy is a very common condition, and it affects all races and ages, including infants. About 1% to 2% of adults have the skin rash, and it is even more common in children. Most affected individuals have their first episode before 5 years of age. For most, the dermatitis will improve with time. For an unlucky few, atopic dermatitis is a chronic, recurrent disorder.
Other eczematous dermatoses include, but are not limited to, allergic contact dermatitis (cell-mediated allergy to a common substance such as poison oak or nickel), irritant dermatitis (from excessive contact with a harsh chemical substance), fungal infections, scabies infestations, stasis dermatitis, very dry skin (asteatosis), pompholyx (dyshidrosis), nummular dermatitis, and seborrheic dermatitis. The differentiation among these conditions is often difficult and time-consuming. In addition, it is not uncommon for atopic dermatitis to coexist with another eczematous dermatitis.
Eczema Causes
It is generally agreed that the tendency to atopy is genetically inherited. For the purposes of this discussion the term eczema and atopic dermatitis will be synonymous. Individuals with atopic dermatitis have a variety of abnormal immunologic findings like elevated IgE antibody (immunoglobulin E) levels and defective cell-mediated immunity which causes difficulty in fighting off certain viral, bacterial, and fungal infections.
Like most other noninfectious diseases, atopic skin disease can be triggered by environmental factors.
One of the hallmarks of atopic dermatitis is excessive skin dryness, which seems to be due a lack of certain skin proteins. Any factor that promotes dryness is likely to exacerbate atopic dermatitis.
Common triggers of atopic dermatitis include the following:
Harsh soaps and detergents
Solvents
Low humidity
Lotions
Rough wool clothing
Sweating
Occlusive rubber or plastic gloves
Rubbing
Staphylococcal bacteria
Repeated wetting and drying of the skin (food handling)
Eczema Treatment
Treatment for eczema can be managed at home by changing laundry detergents or soaps that may be causing the irritant. Avoid tight-fitting or rough clothing. Avoid scratching the affected area
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