Atopic Eczema : Description, Cause, Natural Tratment, And Advice For Patient
Description
● Eczema (or dermatitis) is characterized by papules and vesicles on an erythematous base
● Atopic eczema is the most common type - usually develops by early childhood and resolves during teenage years (but may recur)
Epidemiology
● 20% prevalence in <12 years old in the UK
Causes
● Not fully understood, but a positive family history of atopy (i.e. eczema, asthma, allergic rhinitis) is often present
● A primary genetic defect in skin barrier function (loss of function variants of the protein filaggrin) appears to underlie atopic eczema
● Exacerbating factors such as infections, allergens (e.g. chemicals, food, dust, pet fur), sweating, heat and severe stress
Presentation
● Commonly present as itchy, erythematous dry scaly patches
● More common on the face and extensor aspects of limbs in infants, and the flexor aspects in children and adults
● Acute lesions are erythematous, vesicular and weepy (exudative)
● Chronic scratching/rubbing can lead to excoriations and lichenification
● May show nail pitting and ridging of the nails
Management
● General measures - avoid known exacerbating agents, frequent emollients +/- bandages and bath oil/soap substitute
● Topical therapies – topical steroids for flare-ups; topical immunomodulators (e.g. tacrolimus, pimecrolimus) can be used as steroid-sparing agents
● Oral therapies - antihistamines for symptomatic relief, antibiotics (e.g. flucloxacillin) for secondary bacterial infections, and antivirals (e.g. aciclovir) for secondary herpes infection
● Phototherapy and immunosuppressants (e.g. oral prednisolone, azathioprine, ciclosporin) for severe non- responsive cases
Complications
● Secondary bacterial infection (crusted weepy lesions)
● Secondary viral infection - molluscum contagiosum (pearly papules with central umbilication), viral warts and eczema herpeticum
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ReplyDeleteVery Informative content on eczema Thank you for the article!