Atopic eczema

Atopic eczema is a chronic, relapsing, inflammatory skin condition characterised by an itchy red rash that favours the skin creases such as the folds of the elbows or behind the knees.�

1. ATOPIC ECZEMA
By- Dr. Armaan Singh

2. Atopic eczema is a chronic,
relapsing, inflammatory skin
condition characterised by an
itchy red rash that favours the
skin creases such as the folds
of the elbows or behind the
knees.

3. TRIGGER FACTORS
OIrritants, eg soaps and detergents (including shampoos, bubble baths,
shower gels and washing-up liquids).
OSkin infections: Staphylococcus aureus is believed to be an important
exacerbating factor in atopic eczema.
OContact allergens.
OExtremes of temperature and humidity. Most patients improve in
summer and are worse in winter. Sweating induced by heat or exercise
can provoke an exacerbation.
[
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OAbrasive fabrics, eg wool.
ODietary factors aggravate atopic eczema in about 10% of children but
much less frequently in adults.

Food allergy should be suspected in
children with atopic eczema who have reacted previously to a food, with
immediate symptoms, or in infants and young children with moderate or
severe atopic eczema that has not been controlled by optimum
management, particularly if associated with gut dysmotility (colic,
vomiting, altered bowel habit) or failure to thrive.
OStress may exacerbate atopic eczema, which itself may be a cause of
psychological distress.
OHormonal changes in women - eg premenstrual flare-ups, deterioration in
pregnancy.

4. DIFFERENTIAL DIAGNOSIS
OPsoriasis
OContact dermatitis
OSeborrhoeic dermatitis
OFungal infections
OLichen simplex chronicus
OScabies and other infestations

5. INVESTIGATIONS
OEstimation of immunoglobulin E (IgE) and
specific radio allergosorbant tests (RASTs) only
confirm the atopic nature of the individual.
OSwabs for bacteriology are particularly useful if
patients do not respond to treatment, in order
to identify antibiotic-resistant strains of S.
aureus or to detect additiona lstreptococcal
infection.

6. INVESTIGATIONS
OEstimation of immunoglobulin E (IgE) and
specific radio allergosorbant tests (RASTs) only
confirm the atopic nature of the individual.
OSwabs for bacteriology are particularly useful if
patients do not respond to treatment, in order
to identify antibiotic-resistant strains of S.
aureus or to detect additiona lstreptococcal
infection.