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DERMATOLOGY

Theme :

Echzema Dermatitis

Teacher : Suzanna Abdulovna

Student : Muhammad Nooraiman Ahmad

Noordin

Group : 30
 Definition

Eczema is a term for several different types of skin swelling. Eczema is also calleddermatitis. It is
not dangerous, but most types cause red, swollen and itchy skin. Factors that can cause eczema
include other diseases, irritating substances, allergies and your genetic makeup. Eczema is not
contagious.

The most common type of eczema is atopic dermatitis. It is an allergic condition that makes your
skin dry and itchy. It is most common in babies and children.

Eczema is a chronic disease. You can prevent some types of eczema by avoiding irritants, stress, and
the things you are allergic to

Eczema inflammation of the epidermis (the outer layer of the skin)

Symptoms

The term eczema is broadly applied to a range of persistent skin conditions. These include dryness
and recurring skin rashes that are characterized by one or more of these symptoms: redness,
skin edema (swelling), itching and dryness, crusting, flaking, blistering, cracking, oozing, or
bleeding. Areas of temporary skin discoloration may appear and are sometimes due to
healed injuries. Scratching open a healing lesion may result in scarring and may enlarge the rash.

Factors that worsen atopic dermatitis

Most people with atopic dermatitis also have Staphylococcus aureus bacteria on their skin. The
staph bacteria multiply rapidly when the skin barrier is broken and fluid is present on the skin,
which in turn may worsen symptoms, particularly in young children.

Other factors that can worsen signs and symptoms of atopic dermatitis include:

Dry skin

Long, hot baths or showers

Stress

Sweating

Rapid changes in temperature

Low humidity

Solvents, cleaners, soaps or detergents

Wool or man-made fabrics or clothing

 Dust or sand

Cigarette smoke

Living in cities where pollution is high

Certain foods, such as eggs, milk, fish, soy or wheat

Classification

The term eczema refers to a set of clinical characteristics. Classification of the underlying diseases
has been haphazard and unsystematic, with many synonyms used to describe the same condition. A
type of eczema may be described by location (e.g., hand eczema), by specific appearance
(eczema craquele or discoid), or by possible cause (varicose eczema). Further adding to the
confusion, many sources use the term eczema for the most common type of eczema (atopic
dermatitis) interchangeably.
Common

Atopic eczema (aka infantile e., flexural e., atopic dermatitis) is an allergic disease believed
to have a hereditary component and often runs in families whose members also have asthma.
Itchy rash is particularly noticeable on head and scalp, neck, inside of elbows, behind knees, and
buttocks. Experts are urging doctors to be more vigilant in weeding out cases that are, in
actuality, irritant contact dermatitis. It is very common in developed countries, and rising.
Contact dermatitis is of two types: allergic (resulting from a delayed reaction to
some allergen, such as poison ivy or nickel), and irritant (resulting from direct reaction to a
detergent, such as sodium lauryl sulfate, for example). Some substances act both as allergen and
irritant (wet cement, for example). Other substances cause a problem after sunlight exposure,
bringing on phototoxic dermatitis. About three quarters of cases of contact eczema are of the
irritant type, which is the most common occupational skin disease. Contact eczema is curable,
provided the offending substance can be avoided and its traces removed from one's
environment.

Xerotic eczema (aka asteatotic e., e. craquele or craquelatum, winter itch, pruritus hiemalis)
is dry skin that becomes so serious it turns into eczema. It worsens in dry winter weather, and
limbs and trunk are most often affected. The itchy, tender skin resembles a dry, cracked, river
bed. This disorder is very common among the older population. Ichthyosis is a related disorder.
 Seborrhoeic dermatitis or Seborrheic dermatitis ("cradle cap" in infants) is a condition
sometimes classified as a form of eczema that is closely related to dandruff. It causes dry or
greasy peeling of the scalp, eyebrows, and face, and sometimes trunk. The condition is harmless
except in severe cases of cradle cap. In newborns it causes a thick, yellow crusty scalp rash
called cradle cap, which seems related to lack of biotin and is often curable.

Less common

Dyshidrosis (aka dyshidrotic e., pompholyx, vesicular palmoplantar dermatitis, housewife's

eczema) only occurs on palms, soles, and sides of fingers and toes. Tiny opaque bumps
calledvesicles, thickening, and cracks are accompanied by itching, which gets worse at night. A
common type of hand eczema, it worsens in warm weather.
Discoid eczema (aka nummular e., exudative e., microbial e.) is characterized by round spots
of oozing or dry rash, with clear boundaries, often on lower legs. It is usually worse in winter.
Cause is unknown, and the condition tends to come and go.

Venous eczema (aka gravitational e., stasis dermatitis, varicose e.) occurs in people with
impaired circulation, varicose veins and edema, and is particularly common in the ankle area of
people over 50. There is redness, scaling, darkening of the skin and itching. The disorder
predisposes to leg ulcers.

Dermatitis herpetiformis (aka Duhring's Disease) causes intensely itchy and typically
symmetrical rash on arms, thighs, knees, and back. It is directly related to celiac disease, can
often be put into remission with appropriate diet, and tends to get worse at night.

Neurodermatitis (aka lichen simplex chronicus, localized scratch dermatitis) is an itchy area
of thickened, pigmented eczema patch that results from habitual rubbing and scratching.
Usually there is only one spot. Often curable through behavior modification and anti-
inflammatory medication. Prurigo nodularis is a related disorder showing multiple lumps.

Autoeczematization (aka id reaction, autosensitization) is an eczematous reaction to an

infection with parasites, fungi, bacteria or viruses. It is completely curable with the clearance of
the original infection that caused it. The appearance varies depending on the cause. It always
occurs some distance away from the original infection.

There are also eczemas overlaid by viral infections (e. herpeticum, e. vaccinatum), and
eczemas resulting from underlying disease (e.g. lymphoma). Eczemas originating from
 ingestion of medications, foods, and chemicals, have not yet been clearly systematized. Other
rare eczematous disorders exist in addition to those listed here.

Cause

The exact cause of atopic dermatitis (eczema) is unknown, but it's likely due to a
combination of dry, irritable skin with a malfunction in the body's immune system. Stress
and other emotional disorders can worsen atopic dermatitis, but they don't cause it.

Most experts believe atopic dermatitis has a genetic basis. It has been thought to be
connected to asthma and hay fever, but that theory is being questioned. Not all people with
atopic dermatitis have asthma or hay fever, and not all people with asthma or hay fever
develop atopic dermatitis, but these diseases do seem to be present together in families of
those affected

Complications

Neurodermatitis. Prolonged itching and scratching may increase the intensity of the itch,
possibly leading to neurodermatitis (lichen simplex chronicus). Neurodermatitis is a condition in
which an area of skin that's frequently scratched becomes thick and leathery. The patches can be
raw, red or darker than the rest of your skin. Persistent scratching can also lead to permanent scars
or changes in skin color.

Skin infections. Sometimes, scratching can break the skin and cause open sores and fissures
that can become infected, a process called impetiginization. A milder form of infection is impetigo,
usually due to staphylococcal infection. Having atopic dermatitis predisposes you to this infection.

Eye complications. Severe atopic dermatitis can also cause eye complications, which may
lead to permanent eye damage. When these complications occur, itching in and around the eyelids
becomes severe. Signs and symptoms of eye complications also include eye watering and
inflammation of the eyelid (blepharitis) and the lining of the eyelid (conjunctivitis). If you suspect
complications with your eyes, see your doctor promptly.

Prevention

Those with eczema should not get the smallpox vaccination due to risk of developing eczema
vaccinatum, a potentially severe and sometimes fatal complication

Treatments and drugs

 Treatments for atopic dermatitis (eczema) aim to reduce inflammation, relieve itching and prevent
future flare-ups. Over-the-counter (nonprescription) anti-itch creams and other self-care measures
may help control mild atopic dermatitis.

Although atopic dermatitis is related to allergies, eliminating allergens is rarely helpful in clearing
the condition. Occasionally, items that trap dust such as feather pillows, down comforters,
mattresses, carpeting and drapes can worsen the condition. Allergy shots usually aren't
successful in treating atopic dermatitis.

Medications

Corticosteroid creams or ointments. Your doctor may recommend prescription

corticosteroid creams or ointments to ease scaling and relieve itching. Some low-potency
corticosteroid creams are available without a prescription, but you should always talk to your
doctor before using any topical corticosteroid. Side effects of long-term or repeated use can include
skin irritation or discoloration, thinning of the skin, infections, and stretch marks on the skin.

Antibiotics. You may need antibiotics if you have a bacterial skin infection or an open sore or
fissure caused by scratching. Your doctor may recommend taking antibiotics for a short time to treat
an infection or for longer periods of time to reduce bacteria on your skin and to prevent recurrent
infections.

Oral antihistamines. If itching is severe, oral antihistamines may help. Diphenhydramine

(Benadryl, others) can make you sleepy and may be helpful at bedtime. If your skin cracks open,
your doctor may prescribe mildly astringent wet dressings to prevent infection.

Oral or injected corticosteroids. For more severe cases, your doctor may prescribe oral
corticosteroids, such as prednisone, or an intramuscular injection of corticosteroids to reduce
inflammation and to control symptoms. These medications are effective, but can't be used long term
because of potential serious side effects, which include cataracts, loss of bone mineral
(osteoporosis), muscle weakness, decreased resistance to infection, high blood pressure and
thinning of the skin.

Immunomodulators. A class of medications called immunomodulators, such as tacrolimus

(Protopic) and pimecrolimus (Elidel), affect the immune system and may help maintain normal skin
texture and reduce flares of atopic dermatitis. This prescription-only medication is approved for
children older than 2 and for adults. Due to possible concerns about the effect of these medications
on the immune system when used for prolonged periods, the Food and Drug Administration
recommends that Elidel and Protopic be used only when other treatments have failed or if someone
can't tolerate other treatments.

Light therapy (phototherapy)

As the name suggests, this treatment uses natural or artificial light. The simplest and easiest form of
phototherapy involves exposing your skin to controlled amounts of natural sunlight. Other forms of
light therapy include the use of artificial ultraviolet A (UVA) or ultraviolet B (UVB) light including
the more recently available narrow band ultraviolet B (NBUVB) either alone or with medications.

Though effective, long-term light therapy has many harmful effects, including premature skin aging
and an increased risk of skin cancer. For these reasons, it's important to consult your doctor before
using light exposure as treatment for atopic dermatitis. Your doctor can advise you of possible
advantages and disadvantages of light exposure in your specific situation.

Infantile eczema
Treatment for infantile eczema includes identifying and avoiding skin irritations, avoiding extreme
temperatures, and lubricating your babys skin with bath oils, lotions, creams or ointments.

See your baby's doctor if these measures don't improve the rash or if the rash looks infected. Your
baby may need a prescription medication to control his or her symptoms or to treat the infection.
Your doctor may recommend an oral antihistamine to help lessen the itch and to cause drowsiness,
which may be helpful for nighttime itching and discomfort