Eczema

more about Eczema

Also known as

Atopic Dermatitis

Description

  • This skin disorder is generally attributed to a malfunction in the body’s immune system.  It tends to occur in people who have a family history of allergies.  Many children who get this disease outgrow it at puberty, but later develop dermatitis of the hands as adults.  Risk factors may include exposure to tobacco smoke, Skin Infections, changes in climate, irritating chemicals, food allergies, and stress.

Symptoms

  • Skin (all or some may occur)
  • Dry Scaly Skin
  • Thickened skin
  • Red patches with weepy or thickened skin
  • Tends to occur on face, neck, upper trunk, wrists, hands, in the folds behind the knee and elbow
  • Itching — may be severe

How the diagnosis is made

  • Skin biopsy if diagnosis is unclear
  • Food challenges to see if certain foods are causing the condition
  • Increased eosinophils may be present in the blood
  • Increased level of IgE antibodies may be present

Treatment

  • General:
    1. Avoid drying or irritating the skin
    2. No more than one shower or bath per day, and do not sit in a soapy bath
    3. Only use soap on armpits, groin, and feet
    4. Uses soaps that do not dry skin, such as Dove, Aveeno, Basis, or Cetaphil.
    5. Pat skin dry after shower/bath — do not rub.
    6. Before skin is completely dry, cover with an agent that helps hold in moisture, such as Eucerin, Vaseline, or mineral oil.
    7. Avoid scratchy clothes (often cotton is the best)
    8. Avoid foods that tend to trigger (do challenges to determine which ones may trigger — most common are wheat and dairy).  Only 30% of those affected are worsened by certain foods.
  • Medication options (choices depend on type lesion, e.g., scaly or weeping):
    1. Corticosteroid creams
      Doxepin cream
    2. Antihistamines such as Zyrtec to treat itching
    3. 5% Aquaphor or Fototar cream
    4. Oral corticosteroids for 2-4 weeks
    5. Kenalog (a steroid) injection
    6. Antibiotics such as Keflex if there is Staphylococcus infection
    7. Phototherapy
  • For weeping lesions:

– Saline, bicarbonate or Domeboro tablets in water, colloidal oatmeal (Aveeno) — can use two to four times per day for 10-30 minutes

Complications

  • Herpes Simplex infection (appears as blisters or crusty scabs) may occur in areas that have been treated with corticosteroid creams.  This can be treated with acyclovir or similar medication.

Similar Conditions

  • Impetigo