Eczema is inflammation of the skin characterized by pruritic, edematous, erythematous skin rashes. It is a common condition affecting millions of individuals across the globe.
Presentation
Eczema is of several types and the signs and symptoms vary with each condition [6]. However, there are certain common manifestations of eczema that remain the same irrespective of the type of condition. Some of the common signs include redness of the skin, inflammation and pruritus. In some cases, the lesions may ooze and scarring can occur. The rashes that develop turn extremely itchy combined with dry and flaky skin making condition worse for individuals. The areas that are mostly affected include the face, hands, and folds of arms and back of knees.
Entire Body System
- Swelling
Scratching the skin can cause it to turn red, and to swell and itch even more. Eczema is not contagious. The cause of eczema is unknown. It is likely caused by both genetic and environmental factors. [medlineplus.gov]
This fluid causes swelling, redness, itching, and pain. [healthline.com]
Scratching leads to redness, swelling, cracking, “weeping” clear fluid, crusting, and scaling. Often, the skin gets worse (flares), and then it improves or clears up (remissions). [niams.nih.gov]
These topical medications help decrease the inflammation in the skin, thereby decreasing itching and swelling. Many topical steroids in various strengths are available. [childrensnational.org]
Veins in the lower legs fail to return blood efficiently, causing pooling of blood and fluid buildup and swelling. This swelling leads to skin irritation and darkening, especially around the ankles. [webmd.com]
Respiratoric
- Rhinitis
BACKGROUND: Atopic eczema (AE) is a common skin problem that impairs quality of life and is associated with the development of other atopic diseases including asthma, food allergy and allergic rhinitis. [ncbi.nlm.nih.gov]
[…] allergic rhinitis in 6,836,063 person years at risk in England and Wales. [doi.org]
Often there is someone else in the family with eczema, asthma or hayfever (allergic rhinitis), but this is not always the case. [uichildrens.org]
- Common Cold
Other triggers include harsh clothing such as dry climates, cold air, illnesses such as the common cold and stress. No parent wants to see their child suffer with a rash. [acaai.org]
These are several common triggers: Harsh soaps Cigarette smoke Saliva Nickel Harsh fabrics (such as wool) Illness, including common colds Perfumed or harsh cleaners. Wash all clothes and bed linens in a mild detergent. [nationwidechildrens.org]
Being unwell, for example having a common cold cancause a flare-up. Infections with bacteria or viruses can worsen AE. [britishskinfoundation.org.uk]
- Nasal Congestion
congestion, sneezing, or hives caused by pollen, dust mites, or animal allergy with few side effects.[1] Antihistamines are usually for short-term treatment.[1] Chronic allergies increase the risk of health problems which antihistamines might not treat [en.wikipedia.org]
Gastrointestinal
- Vomiting
Symptoms of an electrolyte imbalance may include: Weakness Nausea Vomiting Loss of appetite Muscle cramps Confusion Feb. 16, 2019 [mayoclinic.org]
There are fairly low rates of side effects in patients on desmopressin, but they can include Headache Nausea and vomiting Dizziness The main concern with desmopressin is overdosing, as this can cause your body to retain too much water. [diabetes.co.uk]
They may also be irritable and experience fevers, diarrhea, and vomiting. Recurrent episodes of dehydration can lead to slow growth and delayed development. [medicinenet.com]
We found no evidence of an increase in adverse events; those reported in included studies that were related to treatment were tummy and gut upset with diarrhoea, constipation, vomiting, and colic pains ( low-quality evidence ). [cochrane.org]
Children may become listless and feverish, experience vomiting and diarrhea, and may show delayed growth. Other people unable to help themselves to water, such as people with dementia, are also at risk of dehydration. [medicalnewstoday.com]
- Nausea
Symptoms of an electrolyte imbalance may include: Weakness Nausea Vomiting Loss of appetite Muscle cramps Confusion Feb. 16, 2019 [mayoclinic.org]
There are fairly low rates of side effects in patients on desmopressin, but they can include Headache Nausea and vomiting Dizziness The main concern with desmopressin is overdosing, as this can cause your body to retain too much water. [diabetes.co.uk]
Minor gastrointestinal symptoms (nausea, vomiting, diarrhoea, colic) were the most common ( Bamford 1985 ; Finlay 2001 ; France 1988 ; Fraser 2001 ; Hederos 1996 ; Henz 1999 ; Kenicer 2001 ; Takwale 2003 ; Valsecchi 2006 ). [doi.org]
Skin
- Eczema
There is not yet a full cure for eczema, but symptoms can be managed. Eczema is not a contagious condition. Symptoms Eczema can cause dry and itchy rashes. Image credit: G Steph Rocket, 2015. [medicalnewstoday.com]
You are here What is eczema? The word eczema simply means dermatitis, which is an inflammation of the skin. There are different types of dermatitis or eczema. The most common type of eczema in children is atopic eczema. [uichildrens.org]
Eczema often runs in families with a history of eczema or other allergic conditions such as hay fever and asthma. It is not contagious. Eczema Symptoms Because eczema is a chronic skin problem, these symptoms can come and go. [healthychildren.org]
Back to top Eczema pictures Eczema typically produces a red, itchy, scaly rash, but exact symptoms can differ from person to person. What eczema looks like may depend on the type of eczema. [health.com]
Eczema Eczema is an allergic skin condition also known as atopic dermatitis. It is a chronic condition that affects mainly children and infants, and the main characteristic of eczema is skin that is itchy and dry that also flakes and scales. [premierallergyohio.com]
- Dermatitis
The word "eczema" is also used specifically to talk about atopic dermatitis, the most common type of eczema. "Atopic" refers to a collection of diseases involving the immune system, including atopic dermatitis, asthma, and hay fever. [medicalnewstoday.com]
Adults with atopic dermatitis may have thicker areas of very dry and itchy, scaly skin. [uclahealth.org]
All eczematous dermatitis, whether due to a familial atopic dermatitis or an acquired allergic contact dermatitis, has a similar appearance. [emedicinehealth.com]
Persistent atopic dermatitis See more images of atopic dermatitis and flexural dermatitis ... Does atopic dermatitis persist forever? Atopic dermatitis affects 15–20% of children but is much less common in adults. [dermnetnz.org]
Stasis dermatitis Stasis dermatitis happens when there is a problem with circulation to the legs Stasis dermatitis is also called gravitational dermatitis, venous eczema and venous stasis dermatitis. [nationaleczema.org]
- Sweating
Put on a pair of wet pajamas or wet long underwear, followed by dry pajamas or a sweat suit; cover the hands and feet with wet cotton tube socks, followed by dry cotton tube socks. [coloradoallergy.com]
Getty Images 3/8 Look for Triggers Then, on your own, start paying attention to whether your eczema tends to be set off by something specific —stress, changes in temperature, sweat, dust mites, and allergies are all common triggers. [allure.com]
“Diseases of the eccrine and apocrine sweat glands.” In: Bolognia JL, Jorizzo JL, et al, eds. Dermatology. Mosby Elsevier 2008. p. 543. [aad.org]
Different triggers can make eczema worse, including environmental stress, allergies, and sweating. [childrensnational.org]
Wear cotton gloves under plastic gloves to soak up sweat from your hands. Take occasional breaks and remove your gloves. This will prevent a buildup of sweat inside your gloves. Wear gloves when you go outside during the winter. [familydoctor.org]
- Skin Rash
Eczema is inflammation of the skin characterized by pruritic, edematous, erythematous skin rashes. It is a common condition affecting millions of individuals across the globe. [symptoma.com]
According to the Mayo Clinic, the condition isn’t an “itchy rash” but skin itch that becomes a rash as the patient scratches. But without scratching, no rash forms! [goodmandermatology.com]
In infancy: Red, very itchy dry patches of skin Rash on the cheeks that often begins at 2 to 6 months of age Rash oozes when scratched. [my.clevelandclinic.org]
A 12-year-old girl, who has had a history of intermittent skin rashes since infancy, presents for the sixth time in four months for exacerbation of eczema that is not responding to recommended treatment (daily baths, frequent moisturization and twice-daily [ncbi.nlm.nih.gov]
These include dryness and recurring skin rashes that are characterized by one or more of these symptoms: redness, skin edema (swelling), itching and dryness, crusting, flaking, blistering, cracking, oozing, or bleeding. [patientslikeme.com]
- Eruptions
Eczematous eruptions, however, are rarely reported, with disseminated eczema in particular being infrequently seen and likely underrecognized. [ncbi.nlm.nih.gov]
Dermatologists can use a wide variety of treatments for eczematous eruptions; however, topical corticosteroids are often the first choice. [pathwaymedicine.org]
In the eczematous drug eruptions, 3 the situation in regard to testing is much [jamanetwork.com]
But of all the local means for the removal of limited eczematous eruptions, none are equal to blistering them. [books.google.ro]
[…] oozing vesicular lesions which become scaly, crusted, or hardened ec·zem·a·tous play \ig-ˈze-mə-təs\ adjective See eczema defined for English-language learners See eczema defined for kids Origin of eczema New Latin, from Greek ekzema, from ekzein to erupt [web.archive.org]
Neurologic
- Irritability
Adults who developed atopic dermatitis as a child but no longer experience the condition may still have dry or easily-irritated skin, hand eczema, and eye problems. [medicalnewstoday.com]
Skin itch may be triggered by allergies, irritation, stress, or infections. Direct stimulation of the patient’s skin can cause irritation, or irritating sweat, cleansers, fabrics, temperatures, or chemicals may be the cause. [goodmandermatology.com]
Eczema triggers might include: Skin irritants: Irritants are substances that cause burning, itching, or redness. They include harsh soaps, chemicals, perfumes, and skin care products that contain fragrance or alcohol. [my.clevelandclinic.org]
Some patients are very easily irritated by sweat and may have more problems during the summer months. Sudden changes in temperature are irritating to patients. [luriechildrens.org]
She recommends using mineral formulas with zinc oxide and titanium dioxide, which are not irritating to the skin. [womenshealthmag.com]
- Feeling of Relaxation
Guided imagery or 'visualisation': learning to use imagery associated with relaxation or calmness and attempting to induce the related feeling in one's own body. [doi.org]
- Vertigo
In addition, they may be used to treat insomnia, motion sickness, or vertigo caused by problems with the inner ear. H2-antihistamines bind to histamine H2 receptors in the upper gastrointestinal tract, primarily in the stomach. [en.wikipedia.org]
Workup
Diagnosis of eczema initially begins with collecting past medical history of the affected individual followed by careful physical examination of the skin rashes. Many a times, diagnosis of eczema is mistaken for food allergies and it is therefore required that more methods need to be carried out for arriving at a definite conclusion. In view of this, the practice of conducting skin biopsy for diagnosing eczema is widely accepted [7].
Treatment
Eczema cannot be cured; the symptoms however can be controlled with appropriate treatment regime. The following are the various methods administered for treating eczema and its several forms:
- Maintaining hygiene: Affected individuals are recommended to keep themselves clean and dry. Bathing regularly once or twice day is advised. It is also necessary to avoid application of soap or other cleaning agents on the affected area as these would further aggravate the existing condition by drying the skin.
- Moisturizers: Individuals suffering from eczema are advised to apply moisturizers once or twice day to keep their skin moisturized and hydrated all day long. This would prevent drying of the skin which in turn would prevent flare ups [8].
- Medications: Medications such as corticosteroids are recommended only when there are flare ups. If the condition can be well managed with moisturizers then corticosteroids may not necessary. Depending on the severity of the condition, potency of the drugs is adjusted.
- Immunosupressants: These are given for short periods to control the skin condition. FDA has warned against use of such medications for prolong periods as these are known to have adverse side effects [9].
- Phototherapy: Phototherapy or light therapy using ultraviolet rays have also been used for effective management of eczema [10].
Prognosis
The prognosis of the disease condition is favorable with topical ointments and ultraviolet therapy. Children, who develop eczema often, undergo complete recovery by the time they reach adolescence. However, in about 2% of cases, treatments with topical ointments and ultraviolet light therapy do not work.
Etiology
The exact etiology behind the development of eczema still remains unclear. However, researchers have postulated the fact that interplay of both environment and genetic factors can play a major role in causation of eczema [2]. Exposure to unhygienic or dirty environment can trigger the development of skin rashes. Individuals who are allergic to dust mites can also suffer from eczema. Several genes have been identified to play foul in development of eczema; the important one being filaggrin [3].
Epidemiology
Eczema is the most common type of skin disease in children. It is known to affect 5 – 20% children across the globe. About 11% of the population of United States suffers from atopic dermatitis, a form of eczema [4]. In the year 2010, eczema affected as much as 230 million individuals across the globe.
Pathophysiology
The actual mechanism that triggers the epidermal layer of the skin to develop rash is not yet clear. The epidermis is the primary line of defense that safeguards the body from various forms of irritants and pollutants. When this layer is intact, no type of allergens can do any harm to the body [5].
In the condition of eczema, the skin loses its natural ability to retain moisture causing the skin to become dry and flaky. Such a development can cause the epidermal layer to get damaged by pollutants and allergic components. Certain immunity factors can also cause eczema. It has been seen that individuals with eczema have elevated levels of serum IgE.
Prevention
So far no guidelines have been designed for preventing eczema. There have been several misconceptions that mother’s diet during pregnancy has some effects on children with eczema. However, there is no such evidence proving that changing one’s diet during pregnancy can prevent development of eczema in children.
Individuals suffering from eczema are advised against receiving the small pox vaccination as they are prone to develop fatal complication of eczema known as eczema vaccinatum.
Summary
Eczema is not a contagious disease condition and can be easily managed and controlled by following a proper treatment regime. Sometimes eczema is used for describing atopic dermatitis as well as atopic eczema. In certain language, eczema is used interchangeably with dermatitis; but in some other cases, eczema means a chronic condition, whereas dermatitis refers to an acute one. However, both eczema and dermatitis are skin conditions wherein the skin develops pruritic rashes that tend to turn red and swell in course of time [1].
Patient Information
Definition
Eczema is a skin disease characterized by dry and red, itchy skin. The disease is also known as dermatitis and is not contagious in nature. Atopic dermatitis is one of the most common forms of eczema. Such a type of skin condition cannot be cured; but the symptoms can be managed well by following a proper treatment regime.
Cause
The exact factors that trigger the development of eczema are yet to be figured out. It is however thought that environment and genetic factors have major role to play in causation of this skin condition. Unhygienic conditions and certain allergens are known to play foul in causation of eczema.
Symptoms
Symptoms of eczema include dry and flaky skin that gets extremely itchy and becomes red and swollen over a period of time. Areas most commonly affected include back of the knees, folds of the arms, face and the neck region.
Diagnosis
Many a times a thorough physical examination is enough for diagnosing eczema. However, in certain cases skin biopsy may also be required for confirming the skin disease.
Treatment
Maintaining appropriate hygiene can help prevent eczema flare ups. In addition, application of moisturizers on the affected area goes a long way in managing the symptoms of eczema. In severe cases, corticosteroids and immunosupressants may also be administered to control the symptoms.
References
- Langan SM, Williams HC. What causes worsening of eczema? A systematic review. Br J Dermatol 2006; 155:504.
- Wu Chang M. Journal Watch, Review of Atopic Dermatitis. Apr 2 2008.
- McGrath JA, Uitto J. The filaggrin story: novel insights into skin-barrier function and disease. Trends Mol Med. Jan 2008;14(1):20-7.
- Shaw TE, Currie GP, Koudelka CW, Simpson EL. Eczema prevalence in the United States: data from the 2003 National Survey of Children's Health. J Invest Dermatol 2011; 131:67.
- Hon KL, Leung AK, Barankin B. Barrier Repair Therapy in Atopic Dermatitis: An Overview. Am J ClinDermatol. Jun 12 2013
- Williams H, Robertson C, Stewart A, et al. Worldwide variations in the prevalence of symptoms of atopic eczema in the International Study of Asthma and Allergies in Childhood. J Allergy ClinImmunol 1999; 103:125.
- Brenninkmeijer EE, Schram ME, Leeflang MM, et al. Diagnostic criteria for atopic dermatitis: a systematic review. Br J Dermatol 2008; 158:754.
- Miller DW, Koch SB, Yentzer BA, et al. An over-the-counter moisturizer is as clinically effective as, and more cost-effective than, prescription barrier creams in the treatment of children with mild-to-moderate atopic dermatitis: a randomized, controlled trial. J Drugs Dermatol 2011; 10:531.
- Grimalt R, Mengeaud V, Cambazard F. The steroid-sparing effect of an emollient therapy in infants with atopic dermatitis: a randomized controlled study. Dermatology. 2007;214(1):61-7.
- Meduri NB, Vandergriff T, Rasmussen H, Jacobe H. Phototherapy in the management of atopic dermatitis: a systematic review. PhotodermatolPhotoimmunolPhotomed 2007; 23:106.