INTERNAL MEDICINE

Eczema

Def: The meaning of the word “eczema” can cause

confusion. Many people use this word to refer to a common skin condition called atopic dermatitis. When this is the meaning, the words “eczema/atopic dermatitis” may be used.

The word “eczema” also has a more general meaning. Eczema can mean a family of skin conditions that causes the skin to become swollen, irritated, and itchy.

Eczema

Clinical classification: Acute eczema Sub-acute eczema Chronic eczema

Eczema

Causes: The exact cause of eczema is unknown, but it's

thought to be linked to an overactive response by the body's immune system to unknown triggers.

In addition, eczema is commonly found in families with a history of other allergies or asthma.

Some people may suffer "flare-ups" of the itchy rash in response to certain substances or conditions. For some, coming into contact with rough or coarse materials may cause the skin to become itchy.

Eczema

Causes: For others, feeling too hot or too cold, exposure to

certain household products like soap or detergent, or coming into contact with animal dander may cause an outbreak. Upper respiratory infections or colds may also be triggers. Stress may cause the condition to worsen.

Although there is no cure, most people can effectively manage their disease with medical treatment and by avoiding irritants. The condition is not contagious and can't be spread from person to person.

Eczema

Pathogenesis: In the acute stage oedema of the epidermis

progresses to intra-epidermal vesicles. In chronic stage more thickening of

epidermis is accompanied by a variable degree of vasodilatation and T-helper lymphocytic infiltration in the upper

dermis.

Eczema

Clinical feature: Itchy rash Vesicles or bullae may appear in the acute stage

if inflammation is intense In subacute eczema the skin may be

erythematous, dry and flaky, odematous andd custered.

Chronic persistent eczema by thickened.

Eczema

Investigation: Patch tests IgE antibody test Prick tests Swab for C/S

Eczema

Management: A)General measures for all types of eczema Explanation, reassurance and encouragement Avoidance of contact with irritants Use of tropical steroids -1% hydrocortisone

applied twice daily

Eczema

Management: B)Specifics measures Irritant contact eczema- use of barrier cream

and protective clothing Allergic contact eczema- avoidance of the culprit

allergens C)Atopic eczema- -avoidance of allergens -regular use of emollients Systemic antibiotics

Eczema

Management: D)Seborrhoeic eczema- local antiseptic, steroid

and antifungal steroid E)Gravitional eczema- local steroids, elimination

of edema by graded compression bandage.