Atopic Eczema

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ATOPIC ECZEMA
DEFINITION
Eczema or atopic dermatitis (from Greek: ἔκζεμα ēkzema) is a form of dermatitis, or inflammation of the epidermis (the outer layer of the skin). It is a common skin condition which afflicts 10-20% of children and 1-3% of adults worldwide, and two in every 10 individuals in Malaysia. The word eczema is derived from Greek words, that mean "to boil over". The terms “eczema” and “dermatitis” are used interchangeably in many languages; by some authors, “dermatitis” is used for the more acute condition, whereas more chronic lesions are classified as “eczema”. The word “eczema” is refers to a group of conditions that show a similar pattern of changes in the skin, giving rise to specific changes on the surface Meanwhile, the word “atopy” can be defined as a group of conditions in which the immune sysytem reacts to allergens in the enviroment by producing raised levels of immunoglobulin type E (IgE) which in turns leads to the changes in the skin. Generally, atopic eczema is a chronic skin disease marked by thickened, scaly, inflamed, and itchy rashes often seen in individuals with familial history of allergic conditions, such as hay fever or asthma CAUSES

It is generally agreed that the tendency to atopy is genetically inherited. People with eczematous dermatitis have a variety of abnormal immunologic findings which are probably related to more than one genetic defect. For example, such individuals tend to have elevated IgE antibody (immunoglobulin E) levels and have difficulty in fighting off certain viral, bacterial, and fungal infections. Like most other noninfectious diseases, atopic skin disease can be triggered by environmental factors. * One of the hallmarks of atopic dermatitis is excessive skin dryness, which seems to be due a lack of certain skin proteins. Any factor that promotes dryness is likely to exacerbate atopic dermatitis. * Common triggers of atopic dermatitis include the following: * Harsh soaps and detergents

* Solvents
* Low humidity
* Lotions
* Rough wool clothing
* Sweating
* Occlusive rubber or plastic gloves
* Rubbing
* Staphylococcal bacteria
* Repeated wetting and drying of the skin (food handling)

SYMPTOMPS
Itching, which is sometimes intense, almost always occurs. Itching may start even before the rash appears. Atopic dermatitis is often called the "itch that rashes" because the itching starts, and then the skin rash appears from the scratching. Typical skin changes may include:

* Blisters with oozing and crusting
* Dry skin all over the body or areas of bumpy skin on the back of the arms and front of the thighs * Ear discharge or bleeding
* Raw areas of the skin from scratching
* Skin coloring changes -- more or less color than the normal skin tone (See: Skin abnormally dark or light) * Skin redness or inflammation around the blisters
* Thickened or leather-like areas, called lichenification, which can occur after long-term irritation and scratching Both the type of rash and where the rash appears can depend on the age of the patient: * In children younger than age 2, skin lesions begin on the face, scalp, hands, and feet. They are often crusting, bubbling, or oozing rashes that itch. * In older children and adults, the rash is more commonly seen on the inside of the knees and elbows, as well as the neck, hands, and feet. * During a severe outbreak, rashes may occur anywhere on the body. TREATMENT

Good skin care is a key component in controlling eczema.  For some people with mild eczema, modifying their skin care regime and making a few lifestyle changes may be all that is needed to treat eczema. Other people with more severe eczema may need to take medications to control their symptoms.  Non-drug treatments for eczema include:

* Mild soap and moisturizer. It's best to use a mild soap to avoid over drying your skin. Gentle soaps, known as syndets, are...
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