Eczema

Atopic eczema is a chronic, inflammatory skin disorder resulting in redness, itching and oozing vesicular lesions that can become scaly or crusted. Nearly ten percent of all children are affected, and although the condition tends to clear up throughout childhood, it afflicts some people for life.

Studies show that some children are born with an imbalance in the immune system that favours the differentiation of certain T-cells. Helper two T-cells proliferate during the initial and acute phases of the disease, whereas helper one T-cells dominate the chronic phases.
Atopic eczema can be caused by allergic reactions to chemicals, metals and plants, or hypersensitivity to soaps and detergents.

Outbreaks can be triggered or exacerbated by anxiety, stress and depression and are often associated with an increase in levels of immunoglobulin E in the blood. Bacterial infection, especially from Staphylococcus aureus, can make the disease worse.

Treating eczema
Patient education and general measures such as the use of emollients and avoiding irritants and excessive heat are important.

For topical therapy, the rule is to use the least potent strength steroid that is effective. Topical antibiotics in combination with a steroid can be used for infected eczema. Other options are tacrolimus or pimecrolimus.

A sedative antihistamine given at night helps reduce the desire to scratch.
More severe and resistant forms may be treated with narrow-band UVB, azathioprine, methotraxate or cyclosporine.


 

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