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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.