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Eczema

Eczema is a form of dermatitis, a skin irritation characterized by red, flaky skin, sometimes with cracks or tiny blisters. It is extremely itchy and in some cases the affected areas of the skin can split and ooze clear fluid. The severity of eczema may vary from person to person.

Types of Eczema


  • Contact eczema is a localized reaction and manifests as redness, itching, and burning where the skin has come into contact with an allergen or irritant.

  • Allergic contact eczema is a type of eczema with red, itchy reaction where the skin has come into contact with a substance that the immune system recognizes as foreign. This can be caused by poison ivy or certain preservatives in creams and lotions.

  • Seborrheic eczema refers to a form of skin inflammation of unknown cause that appears as yellowish, oily, scaly patches of skin on the scalp, face, and occasionally other parts of the body.

  • Nummular eczema refers to a type of coin-shaped patches of irritated skin-most commonly on the arms, back, buttocks, and lower legs-that may be crusted, scaling, and extremely itchy.

  • Dyshidrotic eczema appears as irritation of the skin on the palms of hands and soles of the feet characterized by clear, deep blisters that itch and burn.

Eczema treatment

There are various options for treating eczema though it can be completely cured. Antihistamines and topical immuno-suppressants help clear the affected area. Oral antibiotics may be used for skin infections that arise at the site of an eczema flare-up.

Topical steroids: The type and potency of topical steroid creams is prescribed on the age of the patient and severity of the condition. A thin layer of such creams is applied to affected parts of the skin.

Emollients: They reduce water loss from the skin and reduce dryness. Creams, ointments, lotions and bath oils help in re hydrating dry and cracked areas.

Oral steroids: Oral steroids are generally reserved for eczema that is resistant to all other treatments because this class of drugs is much more likely to cause side effects.

Phototherapy: UV A and B light therapy controls cells in the skin and thereby reduces scaling and sloughing of skin.

Pruritus

Pruritus is a skin disease associated with conditions pertaining to autoimmune disorders and other advanced complications like liver cirrhosis. Pruritus cases vary from mild to complex as the symptoms associated with the condition generally aggravate with age. Untreated pruritus can be a big hindrance to an individual's normal life as it interferes with sleep patterns leading to irritability and stress. In some cases the causative agent for this disease is the Hepatitis C virus which accounts in 20% of the population.


Pruritus occurs mostly in the wrist and ankles as a scratch. The intensity of the itch facilitates other factors such as eczema, impetigo and induced urticaria. The immune response releases histamines causing allergic reactions. The association of pruritus with allergic reactions is identified by the presence of serotonin. The serotonin release caused because of pruritus occurs in case of preexisting medical conditions such as polycythemia, lymphoma and cholestasis.


The identification and diagnosis of pruritus is closely associated with the evaluation of dermatological condition of the patient. Progressive pruritus is noticed with contact dermatitis, urticaria, scabies, pediculous infections of the genital region, folliculitis and xerotic eczema.The factors associated with the respective causes along with pruritus are fomites, dust, bites, chemicals and photosensitivity. Atopic dermatitis induces aggressive form of pruritus. The intense forms of atopic dermatitis associated pruritus usually occur in pregnant women, infants and veterans. Systemic causes of pruritus involve preexisting conditions such as Hodgkin's lymphoma, HIV, scleroderma, multiple myeloma, chronic renal failure and many other conditions.


Pruritus diagnosis involves meticulous procedures in examining the exact history of the patient to rule out other forms of allergic reactions. The information pertaining to the patient history includes several factors such as travel zones, food and occupation. Differentiation of non-septic and septic forms is done to identify systemic involvement of the disease. Secondary infections and malignancies associated have to be identified. Specific sites are identified on the skin reaction to respective drug therapy is carefully monitored.


Pruritus treatment

Avoid stress which delays the healing process. Topical creams are prescribed for allergic forms of pruritus. Skin cleansing is an important step. It is predominantly done to prevent secondary infections and conditions such as psoriasis. Patients who have history of sunburn and sensitivity to extreme temperatures need to relieve the stress upon immune system that reacts immediately to such conditions. Hydration of the skin helps in the restoration of the skin cells to facilitate the process of healing. Change of diet and lifestyle is prescribed to patients who are sensitive foods such as nuts, seafood etc. Patients with a history of contact dermatitis are advised to use skin safe deodorants, shampoos and bubble bath solutions. Oral antihistamines are recommended to ease the immune system's reactivity. Hot water bath and tight clothing are to be avoided in case of pruritus as it may aggravate the condition. Topical creams containing corticosteroids are recommended during the onset of a pruritic reaction. In case of secondary infections associated with pruritus, antibiotics are given.


Dermatitis

Dermatitis is a skin condition characterized by inflammation or localized rash. This is usually caused due to an allergy or irritant. The affected area becomes red and tender and develops crusts, blisters or crusts. The affected skin may develop fluid-filled bumps or fissures. Contact dermatitis occurs when the skin comes into contact with a substance that triggers off an allergy or irritation. Substances that typically cause dermatitis are fragrances in detergents, laundry soap, industrial chemicals, perfumes, hair dyes, nickel jewelry, certain foods and plants. Poison ivy, poison oak and poison sumac are common plant allergens. Allergic dermatitis is a condition where the body's immune system overreacts to a foreign body and produces antibodies. It results in itchy rash. Contact dermatitis is a condition resulting from contact with a substance that causes damage to your skin. Persons suffering from eczema are more susceptible to contact dermatitis. Creams containing hydrocortisone can help in alleviating the symptoms of contact dermatitis. Irritant contact dermatitis is caused due to the direct effect of an irritant substance on the skin. These substances may be found at home or at the work place or garden. Typically allergic contact dermatitis is easily noticed within 48 - 72 hours. Allergic contact dermatitis is a result of hypersensitive skin reacting to a particular substance. Atopic dermatitis is a result of an allergic condition. It is more common in families with allergies to hay fever, asthma and history of sensitive skin. When there is accumulation of fluid beneath your skin tissues, it leads to statis dermatitis. This type of skin condition can arise from various chronic conditions. Seborrheic dermatitis occurs on the scalp and may need to be treated with shampoos containing salicylic acid or ketoconazole. Use of hydrocortisone creams and lotions may also give relief. This condition is known as dandruff. It can affect the face and chest along with creases of the limbs.


Skin tests or patch tests help in clarifying the type of dermatitis. The physician must rule out eczema or psoriasis before looking for possible causes of dermatitis. A patch test can help in narrowing down the substance that triggers the dermatitis so that exposure can be avoided. Small areas of the skin are subjected to different allergens. This patch of skin is then covered and the reactions are noted after 2 days. Any swelling or rash is indicative of allergy towards that particular substance. Since there is no definite cure for atopic dermatitis, the physician will suggest treatment options based on the pattern, duration and severity of the condition. Simple ways of tackling dermatitis:


  • Showering or bathing in lukewarm water
  • Wearing smooth and soft clothes preferably made of natural fibers
  • Applying emollients. It is essential to keep your skin well moisturized. This can reduce the number of flare-ups.
  • Applying topical steroids on affected patches
  • Antihistamines can help in reducing irritation and itching
  • Calamine lotion may relieve itching
  • Wet wraps an help in cooling and moisturizing the skin and protecting it from damage due to scratching.

Tags: #Eczema #Pruritus #Dermatitis
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Collection of Pages - Last revised Date: September 23, 2020