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Eczema |
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Definition
Atopic dermatitis, commonly referred to as eczema, is
a chronic skin disorder categorized by scaly and
itching rashes. People with eczema often have a family
history of allergic conditions like asthma, hay fever,
or eczema.
Causes
A
hypersensitivity reaction (similar to an allergy)
occurs in the skin, causing chronic inflammation. The
inflammation causes the skin to become itchy and
scaly. Chronic irritation and scratching can cause the
skin to thicken and become leathery-textured.
Exposure to environmental irritants can worsen
symptoms, as can dryness of the skin, exposure to
water, temperature changes, and stress.
Symptoms
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
Screening and
Diagnostics
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Skin biopsy if diagnosis is
unclear
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Food challenges to see if certain
foods are causing the condition
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Increased eosinophils may be
present in the blood
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Increased level of IgE antibodies
may be present
Treatment
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Avoid drying or irritating the
skin
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No more than one shower or bath
per day, and do not sit in a soapy bath
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Only use soap on armpits,
groin, and feet
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Uses soaps that do not dry
skin, such as Dove, Aveeno, Basis, or Cetaphil.
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Pat skin dry after shower/bath
-- do not rub.
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Before skin is completely dry,
cover with an agent that helps hold in moisture,
such as Eucerin, Vaseline, or mineral oil.
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Avoid scratchy clothes (often
cotton is the best)
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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.
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Corticosteroid creams
Doxepin cream
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Antihistamines such as Zyrtec
to treat itching
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5% Aquaphor or Fototar cream
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Oral corticosteroids for 2-4
weeks
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Kenalog (a steroid) injection
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Antibiotics such as
Keflex if there is
Staphylococcus infection
Phototherapy
- Saline, bicarbonate
or
Domeboro
tablets in water, colloidal oatmeal (Aveeno) -- can
use two to four times per day for 10-30 minutes
Prognosis
Eczema is a chronic condition, but it may be
controlled with treatment and avoidance of irritants.
Complications
Prevention
Studies have shown that children who are breast-fed
are less likely to get eczema. This is also true when
the nursing mother has avoided cow's milk in her diet.
Other dietary restrictions may include eggs, fish,
peanuts, and soy.
Eczema tends to run in families. Control of stress,
nervousness, anxiety, and depression can be beneficial
in some cases.
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