| ID | 404 |
|---|---|
| Name | ECZEMA1 |
| Cause | Causes of eczema: A. Exogenous- 1. Contact dermatitis- primary irritant e.g nappy rash; allergic e.g neomycin cream. 2. Infection- bacterial or fungal. 3. Physical agents- light, heat, cold. B. Endogenaits- 1. Atopic eczema. 2. Systemic diseases e.g. Wiskott-Aldrich Syndrome, congenital sex-linked agammaglobulinemia, histiocytosis, hartnup disease. |
| Signs Symptoms | They may include: Dry, cracked skin. Itchiness (pruritus) Rash on swollen skin that varies in color depending on your skin color. Small, raised bumps, on brown or Black skin. Oozing and crusting. Thickened skin. Darkening of the skin around the eyes. Raw, sensitive skin from scratching. |
| Diagnosis | Diagnose it by looking at your skin and by asking a few questions. Because many people with eczema also have allergies, Doctor may order some allergy tests to look for irritants or triggers. Children with eczema are especially likely to have allergy tests |
| Investigations | Patch testing on your skin. In this test, small amounts of different substances are applied to your skin and then covered. During visits over the next few days, the doctor looks at your skin for signs of a reaction |
| Management | Management: (General principles)- 1. Acute weeping stage- wet dressing- a piece of cotton cloth or soft linen moistened with potassium permanganate or normal saline is placed over the lesions. This can be moisturised every 20-30 minutes by dropping fresh water into it. Do not use cotton swab or gauze as dressing. This treatment can be repeated 3 or 4 times a day. 2. Scaling dry stage- calamine lotion, hydrocortisone cream or fluorinated steroid cream eg. betnovate cream can be used. 3. Sedation may be required for pruritus eg. chloral hydrate or promethazine. 4. Do not use antihistamine cream which can cause sensitization. 5. Vaccination is contraindicated but triple antigen and polio immunisation can he carried out. 6. Where there is supperimposed bacterial or fungal infection, appropriate antibiotic cream may be used. 7. Avoid precipitating causes if possible. 8. Use a bland non-irritating soap for bathing. |
| Introduction | Eczema, also known as atopic dermatitis, is a skin problem that causes dry, itchy, scaly, red skin. It can affect infants, children, and adults and seems more common in certain families. Eczema can be treated with moisturizers and prescription ointments and creams |
| History | Synonymous with the word dermatitis is the expression eczema, which was first used in 543 by the Greek physician Aatius of Amida and means “to boil out.”2 The Italian physician Girolamo Mercuriali gave an early description of atopic dermatitis in 1572 in his De morbis cutaneis |
| Etiology | Common triggers include: irritants – such as soaps and detergents, including shampoo, washing-up liquid and bubble bath. environmental factors or allergens – such as cold and dry weather, dampness, and more specific things such as house dust mites, pet fur, pollen and moulds |
| Clinical Features | They may include: Dry, cracked skin. Itchiness (pruritus) Rash on swollen skin that varies in color depending on your skin color. Small, raised bumps, on brown or Black skin. Oozing and crusting. Thickened skin. Darkening of the skin around the eyes. Raw, sensitive skin from scratching. |
| Preventions | Eczema Flare-up Prevention Moisturize your skin often. Avoid sudden changes in temperature or humidity. Try not to sweat or get too hot. ... Manage stress, and take time for yourself to relax. ... Avoid scratchy materials such as wool. Don't use harsh soaps, detergents, or solvents |
| Treatment | The main treatments for atopic eczema are: emollients (moisturisers) – used every day to stop the skin becoming dry. topical corticosteroids – creams and ointments used to reduce swelling and redness during flare-ups |
| Complications | Complications of atopic dermatitis (eczema) may include: Asthma and hay fever. ... Food allergies. ... Chronic itchy, scaly skin. ... Patches of skin that's darker or lighter than the surrounding area. ... Skin infections. ... Irritant hand dermatitis. ... Allergic contact dermatitis. ... Sleep problems. |
| Prognosis | Nearly half of children with eczema outgrow the condition or experience improvement by the time they reach puberty. Others will continue to have some form of the condition throughout their life. For adults with eczema, the condition can be well managed with a good skin care routine |
| Types | There are 4 phases of eczema. All phases are characterized by pruritus. 1. Erythema. 2. Formation of microvesicle resulting in oozing, weeping lesion. 3. Scaling. 4. Lichenification and pigmentary disturbances. In the young infant, the first 3 stages predominate and lichenification is not seen. |
| Classification | There are seven kinds of eczema: atopic dermatitis, dyshidrotic eczema, contact dermatitis, discoid or nummular eczema, neurodermatitis, seborrheic dermatitis, and stasis dermatitis |
| Observation | |
| Pathology | Eczema is a common skin condition with multiple clinical patterns, characterised histologically by a spongiotic tissue reaction pattern. The terms eczema and dermatitis are often used interchangeably to denote a polymorphic inflammatory reaction pattern involving the epidermis and dermis |
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