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Eczema (atopic dermatitis)
Alternative namesInfantile eczema; Atopic eczema; Dermatitis - atopic
DefinitionAtopic dermatitis, commonly referred to as eczema, is a chronic skin disorder categorized by scaly and itching rashes. People with eczema often have a family history of allergic conditions like asthma , hay fever , or eczema.
Causes, incidence, and risk factors
Eczema is most common in infants, and at least half of those cases clear by age 36 months. In adults, it is generally a chronic or recurring condition.
Exposure to environmental irritants can worsen symptoms, as can dryness of the skin, exposure to water, temperature changes, and stress.
Signs and testsDiagnosis is primarily based on the appearance of the skin and on personal and family history. The health care provider should examine the lesions to rule out other possible causes. A skin lesion biopsy may be performed, but is not always required to make the diagnosis.
Consult your health care provider for a diagnosis of eczema because it can be difficult to differentiate from other skin disorders. Treatment should be guided by the health care provider.
Dry skin often makes the condition worse. When washing or bathing, keep water contact as brief as possible and use less soap than usual. After bathing, it is important to trap the moisture in the skin by applying lubricating cream on the skin while it is damp. Temperature changes and stress may cause sweating and aggravate the condition.
Mild anti-itch lotions or topical corticosteroids (low potency) may soothe less severe or healing areas, or dry scaly lesions.
Chronic thickened areas may be treated with ointments or creams that contain tar compounds, corticosteroids (medium to very high potency), and ingredients that lubricate or soften the skin. Systemic corticosteroids may be prescribed to reduce inflammation in some severe cases.
The latest treatment for eczema is a new class of skin medications called topical immunomodulators (TIMs). These medications are steroid-free. They include tacrolimus (Protopic) and pimecrolimus (Elidel). Studies have shown as high as an 80% success rate using these new medications.
Expectations (prognosis)Eczema is a chronic condition, but it may be controlled with treatment and avoidance of irritants.
Calling your health care providerCall for an appointment with your health care provider if eczema does not respond to moisturizers or avoiding allergens, if symptoms worsen or treatment is ineffective, or if signs of infection (such as fever, redness, pain) occur.
Studies have shown that children who are breast-fed are less likely to get eczema. This is also true when the nursing mother has avoided cow's milk in her diet. Other dietary restrictions may include eggs, fish, peanuts, and soy.
Eczema tends to run in families. Control of stress , nervousness, anxiety , and depression can be beneficial in some cases.
Update Date: 1/16/2004Jonathan Kantor, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT