Eczema - Medtick
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Eczema

Eczema is very common in babies (one in five) between ages of two to four months old, it normally clears by the age of six years old and more by the time they are teenagers. It can reappear particularly during hay fever season or if one have asthma and/or allergies.

Atopic Eczema

  • It is a long term condition with no cure, when the skin’s waterproof barrier is weakened and as a result one gets dry, itchy and inflamed skin.
  • It can cause ‘flare-ups’ particularly during allergy hay fever season and patients who are asthmatics.
  • It mainly occurs at a young age and (in most cases) generally decreases with age.

DRY SKIN

  • Like atopic eczema except it can occur any age.

Discoid eczema

  • It is a condition that mainly affects males (ages 50- 70 years) or females in their teens to 20 years old.
  • The cause is unknown and the main symptoms are circular patches on the skin.
  • It can cause ‘flare-ups’ and one can have patches get worst or calm down and reappear in different areas (mainly on lower legs , forearm and trunk) or in the same area and is often confused with urticaria.
  • It may be linked to atopic eczema and is also often confused with ringworm.
  • It should be noted that ringworm tends to be few in number where as discoid eczema can be more in number and in multiple areas.

Allergic and irritant contact dermatitis

  • This eczema occurs if one is exposed to an irritant or if anyone is allergic to anything. It can occur at anytime in one’s life.
  • This eczema occurs if one is exposed to an irritant or if anyone is allergic to anything. It can occur at anytime in one’s life.
  • The rash usually appears 48–72 hours after exposure.
  • Certain allergens may penetrate intact skin poorly, and the onset of dermatitis may be delayed up to 1 week after exposure.
  • A minimum of 10 days is required for individuals to develop specific sensitivity to a new contact.
  • The immediate onset of dermatitis after initial exposure to material suggests either a cross-sensitisation reaction, prior forgotten exposure to the substance, or nonspecific irritant contact dermatitis provoked by the agent in question.
  • Immediate reactions (i.e. visible lesions developing < 30 minutes after exposure) indicate contact urticaria and not allergic contact dermatitis.
  • This is particularly true if the lesions are urticarial in appearance and if the skin reaction is associated with other symptoms, such as distant urticaria, wheezing, periorbital oedema (puffy eyes and/or swelling round eyes), runny nose , or anaphylaxis.

Medscape

All types of eczema conditions are increasing and are caused by a variety of triggers that include:

 

Allergies and irritants

(Allergy reactions can still develop even coming in contact with products for years or if have a one off contact) examples include:

  • Soaps, detergent, dyes.
  • Metals, nickel and cobalt in jewellery.
  • Chromate in cement, textiles, adhesives.
  • Cosmetics (hair dye preservatives, nail vanish remover).
  • Rubber including latex.
  • Plants: pollen, daffodils, tulips.
  • Circulating allergens caused by air conditioned room.

 

Pets and animals

  • Fur

 

Food

  • Food intolerance
  • Food allergies

 

Female Hormonal disorder:

  • Period pains
  • Hot flushes
  • Menopause
  • Ectopic Pregnancy
  • Pelvic inflammatory disease
  • Endometriosis
  • Fibroids
  • Polycystic ovaries
  • Ovarian disease
  • Ovarian cancer
  • Cervical disease
  • Cervical cancer
  • Vaginal prolapsed
  • Pregnancy

 

Other hormonal:

  • Puberty

Ageing skin

  • As one gets older we have less active oil producing glands.

 

Social/Psychological Factors

  • Stress
  • Panic attacks
  • Alcohol can make one dehydrated
  • Smoking can cause skin damage

 

Diet

  • Poor diet does not give right nutrients to the skin
  • Not drinking enough water

 

Seasonal

  • Worse in winter Central heating is used more, entering from cold and harsh weather to warm areas and vice versa.
  • Some find UV rays from the sun more harmful especially in summer.

 

Exercise

  • Sweating a lot and working in sweaty environments.
  • The skin exposed to wet and dampness leading to the skin being red and sore or exposed to water especially if hard,
    chalky or heavy
    chlorinated e.g. swimming pools.

 

UV rays and sun beds

 

Family history (not discoid eczema)

 

Standard of living

  • Dust mites thrive in dusty areas
  • Dust
  • Poor ventilated areas

 

Rough and/or layers of clothing

  • Clothes can irritate the skin
  • Layers of clothes cause the skin one to sweat a lot and trap moisture and heat.

 

Excessive water contact

  • Too much water can reduce oil protective layer on the skin and decrease the water proof barrier.
  • One should be less than 20 minutes when having a shower or bath.

 

Diseases

  • Asthma
  • Hayfever
  • Cushing syndrome
  • Cystic fibrosis
  • Dehydration conditions
  • Diabetes
  • Hyperthyroidism
  • Ichthyosis
  • Kidney disorders
  • Long term diarrhoea
  • Lupus
  • Metabolic acidosis
  • Parasite infections
  • Phaeochromocytoma
  • Psoriasis
  • Sweat a lot
  • Threadworm
  • Ulcerative colitis

 

Medication

  • One can be allergic or sensitive to medication
  • Medication cause skin reactions
  • Medications alter hormone balance
  • Medication makes you lose water causing skin dehydration.

Assessment tools used by Healthcare professionals

Symptoms

Does one have:

Eczema (atopic) and dry skin

Eczema rash can occur anywhere, however it does tend to develop in these areas:

  • Neck
  • Cheeks (babies mainly)
  • Scalp (babies mainly)
  • Eyes
  • Wrist
  • Ankles
  • Ears
  • Inside and front of elbows
  • Behind knees
  • Hands (Adults mainly)
  • Skin appear to be like a red/brown rash or burn  (in dark skin it appears shiny, grey /brown with visible hair follicles  but not raised skin)?
  • Skin appear Itchy?
  • Skin appear flaky?
  • Skin appear slightly cracked?
  • Skin appear scaly?
  • Skin appear slightly thickened?
  • Skin appears dry?
  • Skin appear/look bumpy and rough, wetness in appearance?
  • Skin appear cracked?
  • Feeling of tightness after showering, bathing or swimming?
  • Feel a loss of plumpness, dull and shrunkness to the skin?
  • Flare-ups and the skin is hot, red and swollen?
  • Skin very itchy?
  • Exposed to bright sunlight or hot weather (dehydrated)?
Discoid eczema

Eczema rash can occur anywhere, however it does tend to develop in these areas:

  • Feet
  • Forearms
  • Hands
  • Lower legs
  • Body
  • Face, head, neck, scalp (rare)
  • Circular patches on the skin (the size can be from a few millimetres to a few centimetres in size?
  • Patches dry and cracked but not itchy (dry discoid eczema)?
  • Burning or stinging feeling?
Asteatotic eczema
  • Crazy pave-looking appearance on lower legs and shins sometimes on arms and body?
Allergic/irritant contact eczema

Please note: Symptoms might take several hours or days after contact was first made and also some people only develop irritation if repeatedly exposed to that allergan/irritant.

  • Developed an inflamed rash when in contact to anything one is allergic to (the rash can appear in different areas of the body from where contact was made), with an irritant (one normally will only develop a rash in that area to which contact was made)?
  • Skin feel burning?
  • Skin is dry?
  • Skin is itchy?
  • Skin is flaky?
  • Skin is scaly?
  • Skin is slightly cracked?
  • Skin is slightly thickened?
  • Skin is sore and or stinging?
Nail changes:
  • Long term Ingrowing toe nail?
  • Small depressions or little pits in the nail (nail pitting)?
  • Nail plate separates from the nail bed; it causes a white discoloration or loose nail?
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