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What is eczema,cause and treatment

Eczema is a conditions that cause an itchy, inflamed skin and Eczema (also called atopic dermatitis

What is eczema,cause and treatment

Eczema is a conditions that cause an itchy, inflamed skin and Eczema (also called atopic dermatitis) is characterised by dry itchy skin with areas of poorly demarcated erythema and scale. In the acute phase eczema may be vesicular and oozing, in the chronic phase it may become hyperpigmented and lichenified (thickened). Excoriations (scratch marks) are frequently seen. Onset is usually after 3 months of age. In infancy, there is involvement of the face, scalp and extensor surfaces. In childhood, the flexures of the knees and elbows, and extensor surfaces of wrists and ankles are often involved. Flares of eczema can be either localised (with intensely inflamed, weeping and infected skin), or generalised (called erythroderma when >90% of body surface is involved). Flares are almost always associated with infection, especially by Staphylococcus aureus.

Symptoms of eczema

There are many symptoms of eczema that makes the patient’s life uncomfortable; oozing, inflammation, and blistering being the most prominent. When it comes to sores, there are many transformations that take place. If the patient is dark-skinned, then eczema may change the complexion to lighten. Unusually the itchiness associated with this condition becomes worsen at night and patients usually scratch the sores until they bleed. This situation might lead up to an infection and scarring. Therefore, patients are highly advised to avoid scratching. According to medical sources, about 3% of the people in the United States suffer from atopic dermatitis. Surprisingly 80% of the patients have one or more relatives who are suffering from the same condition or similar. Atopic dermatitis can cause problems in any part of the skin and can last for years. While females are reported to be having the most severe consequences (Due to a more sensible skin), atopic dermatitis usually appears on the below mentioned areas in young adults:
Elbow Creases , Backs of the Knees , Ankles , Wrists , Face , Neck , Upper Chest

Types of Eczema

  • Atopic Eczema (Atopic Dermatitis)
  • Contact Dermatitis
  • Varicose Eczema
  • Discoid Eczema
  • Hand Eczema
  • Nummular Eczema
  • Asteatotic Eczema
  • Stasis Dermatitis
  • Lichen Simplex Chronicus
  • Seborrheic Dermatitis (Seborrhea)

Causes of Eczema

Causes of eczema cannot be pinned down to a concrete list because triggering factors vary from person to person. Furthermore, a person may be affected by one or more triggering factors at any given time or else, the triggers may work in combination with a few components but will not trigger eczema when contact is made, individually. These allergens and non-allergens therefore, are specific to person by person and affect them in varying degree.

Some most common allergens for eczema:

Allergens

Ragweed , Animal hair , Animal Dander , Anima Saliva , Tree Pollens , Dust mites , Grass pollens , Fungal spores , Certain bedding stuffing’s , Detergents , Washing powders , Fabric softeners , Skin lotions , Anesthetic creams , Certain Food additives , Some drugs (aspirin, beta-blockers)

Non-Allergens

Sweat , Overheating , Smoke , Manufactured heat (electric blankets) , Stress , Certain fumes , Alcohol , Bleaches , Wool , Excessive exposure to water , Physical exercise , Rough fabrics

Food Allergens

Nuts , Milk , Wheat , Pork , Peanuts , Peanut butter , Shellfish , Eggs

Treatment of eczema

Antibiotics

All children with flares of eczema requiring admission should be treated with antibiotics. It is preferable to give these orally unless there is severe infection or systemic illness. Treatment should be for 7-14days
Some Antibiotics:

  • Flucloxacillin » IV 100mg/kg/day in 4 doses (max 1000mg/dose)
  • Cephalexin »PO 50-75mg/kg/day in 3 doses if flucloxacillin not tolerated
  • Erythromycin » PO 40mg/kg/day in 4 doses (max 500mg/dose) if flucloxacillin not tolerated or penicillin-allergic
  • Co-trimoxazole » PO if flucloxacillin not tolerated
  • Skin swabs should be taken at admission.

Antivirals

Eczema herpeticum is caused by the herpes simplex virus. It causes multiple vesicles or punchedout erosions which may become confluent.

Aciclovir Antivirals :

IV 250mg/square metre/dose 8 hourly (max 500mg/dose) for 5 days.
For infants <3/12 discuss with Infectious Disease service.
Ophthalmology referral should be made for all lesions near the eye. Viral swabs should be taken before commencing treatment. Treatment with topical steroid is contraindicated in the region of herpes infection. Wet wraps are contraindicated in eczema herpeticum. If there is significant infection and crusting it may be necessary to delay wet wraps for the first 24 hours while the infection is brought under control using antibiotics and potassium permanganate baths.






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