WHAT IS ECZEMA?

The term 'eczema' is used in two different ways. It can be used widely to describe any rash-like skin conditions. It is usually used specifically to refer to the most common type of these skin conditions: atopic dermatitis.

Atopic dermatitis is a chronic skin condition that commonly starts during infancy and continues through into childhood. Some people outgrow the condition while some people will continue to have it into adulthood.

The word 'atopic' refers to a collection of diseases for which there is an inherited tendency to develop, including dermatitis, asthma and hay fever. 'Dermatitis' means inflammation of the skin.

There are many different types of eczema. This article will predominantly focus on atopic dermatitis. Other variants include:

• §  Allergic contact eczema (dermatitis) - a reaction where the skin has come into contact with a substance that the immune system recognizes as foreign
• §  Contact eczema - a localized reaction where the skin has come into contact with an allergen
• §  Dyshidriotic eczema - irritation of skin on palms of hands and soles of feet, characterized by blisters
• §  Neurodermatitis - scaly patches of skin on head, forearms, wrists, lower legs caused by localized itch such as an insect bite
• §  Nummular eczema - circular patches of irritated skin that can be crusted, scaling and itchy
• §  Seborrheic eczema - oily, scaly yellowish patches of skin, usually on scalp and face
• §  Stasis dermatitis - skin irritation on lower legs, usually related to circulatory problems.

 

For illustration purposes. (source: http://www.allergy-clinic.co.uk)

 Signs and symptoms of eczema

Atopic dermatitis commonly manifests itself in infants with dry and scaly patches appearing on the skin. These patches are often intensely itchy.⁶ The symptoms of atopic dermatitis can vary, depending on the age of the person with the condition.

Most people develop atopic dermatitis before the age of 5.⁶ Half of people who develop the condition in childhood continue to have symptoms of it as an adult, though these symptoms are often different to those experienced by children.

People with the condition will often experience periods of time where their symptoms will flare up or worsen, followed by periods of time where their symptoms will improve or clear up.

For illustration purposes (source: www.rocketswag.com)

Infants:

• §  Rashes commonly appear on scalp and cheeks
• §  Rashes can bubble up before weeping fluid
• §  Rashes can cause extreme itchiness, which may lead to trouble sleeping. Continuous rubbing and scratching can lead to skin infections.

Children, from 2 years old to puberty:

• §  Rashes commonly appear behind the creases of elbows or knees
• §  Also common on neck, wrists, ankles, crease between buttock and legs.
• Over time, the following symptoms can manifest:
• §  Rashes can become bumpy, like goosebumps
• §  Rashes can lighten or darken in color
• §  Rashes can thicken (also known as lichenification) and then develop knots and a permanent itch.

Adults:

• §  Rashes commonly appear in creases of elbows or knees or nape of neck
• §  Rashes cover much of the body
• §  Rashes can be especially prominent on neck, face and around the eyes
• §  Rashes can cause very dry skin
• §  Rashes can be permanently itchy
• §  Rashes can cause scaly skin (more scaly than in children)
• §  Rashes can lead to skin infections.

Adults who developed atopic dermatitis as a child but no longer experience the condition, can still experience dry or easily irritated skin, hand eczema and eye problems.

How the skin affected by atopic dermatitis will appear is dependent on how much it has is scratched and the presence of any skin infections. Scratching and rubbing irritates the skin further, increases inflammation and make itchiness worse.²

Skin features associated with atopic dermatitis:²

• §  Atopic pleat - an extra fold of skin that develops under the eye
• §  Cheilitis - inflammation of the skin on and around the lips
• §  Hyperlinear palms - increased number of skin creases on the palms
• §  Hyperpigmented eyelids - eyelids that have become darker in color from inflammation or hay fever
• §  Ichthyosis - dry, rectangular scales on the skin
• §  Keratosis pilaris - small, rough bumps, generally on the face, upper arms and thighs
• §  Lichenification - thick, leathery skin resulting from constant scratching and rubbing
• §  Papules - small raised bumps that may open when scratched and become crusty and infected
• §  Urticaria - hives (red, raised bumps) that may occur after exposure to an allergen, at the beginning of flares, or after exercise or a hot bath.