Generality
An eczema, or dermatitis, is an inflammation of the skin that causes a characteristic rash.
The typical manifestations of this rash are: itching, redness, blistering and / or crusting.
There are numerous types of eczema. The most common types of eczema are: atopic eczema, contact dermatitis, seborrheic eczema and asteatosic eczema. Some of the less common eczemas are: dyshidrosis, discoid eczema, varicose eczema, herpetiform dermatitis and neurodermatitis.
What is eczema?
Eczema is the term by which doctors indicate an inflammation of the skin (or skin ), generally characterized by itching, erythema (ie redness), presence of blisters and / or crusting.
There are several types of eczema; each of these types has some peculiarities, which an expert eye is able to recognize.
ECZEMA AND DERMATITIS ARE SYNONYMOUS?
In medicine, the terms eczema and dermatitis are synonymous, therefore they refer to the same inflammatory condition of the skin.
Epidemiology
According to some statistical surveys, people around the world who suffered from eczema in 2010 were around 230 million, or about 3.5% of the world population.
Eczema affects mainly young subjects : for example, in the United Kingdom, children suffering from dermatitis are around 20%; in the United States, about 10%.
The most affected sex is the female one.
Curiously and for reasons still unclear, from 1940 to 2000, the incidence rate of eczema has been increasing. In other words, over the years, eczema has become an increasingly common problem.
An interesting US study of 2010 investigated how widespread eczema was among those working in the United States that year. It emerged that dermatitis affected about 10% of workers (ie more than 15 million individuals) and was particularly widespread among health assistants and social workers.
Causes
The causes of eczema are currently being studied, as doctors and researchers have not yet clarified what triggers and starts the processes of skin inflammation.
According to the most reliable theories, a combination of environmental and genetic factors would contribute to the appearance of eczema.
ENVIRONMENTAL FACTORS
Premise: an environmental factor is any circumstance, event or habit that can affect the life of an individual to a certain extent.
According to some scientific research, the environmental factors linked to the appearance of eczema would be allergic reactions to certain substances (dust mites, drugs, etc.), exposure to certain irritants and some bacterial or fungal infections .
GENETIC FACTORS
Analyzing the genetic profile of numerous patients with eczema, the researchers noted that many subjects under examination expressed some specific genes in a different way from normal.
Furthermore, paying attention to the family history of the same patients and others, they found that eczema was a recurring problem within different households.
These two curious discoveries, therefore, led the experts to think that, in some cases, eczema has a genetic-hereditary basis .
Among the genes that seem to influence the presence of some types of eczema, the gene for filaggrin, a protein found in the epidermis and which binds keratin filaments, deserves a special mention.
Curiosity
For reasons that are still unknown, people with celiac disease develop eczema with a frequency that is three times higher, compared to individuals without this disorder. Read the deepening
Symptoms and Complications
To learn more: Symptoms Dermatitis
Generally, the most characteristic sign of eczema is the rash, also known as rash or exanthema .
An eczema rash may occur with or without blisters; it can be a place of redness, irritation, swelling and / or dry skin; it may coincide with a highly itchy area (that is, itching); may develop suppurative and / or crusted lesions; etc.
SEAT OF THE SKIN ERUPTION
The site of the body, affected by the rash, depends on the type of eczema.
However, the regions most commonly affected are: the neck, the trunk (chest, belly and back), hands, wrists, forearms, legs and ankles.
It is quite rare that the eczema rash appears at the level of the genitals, therefore near the vulva or scrotum. However, when it happens, the symptoms and signs are quite intense and tend to "come and go".
COMPLICATIONS
The complications of eczema are often linked to a very intense itching .
In fact, a particularly marked itchy sensation causes the individual with eczema to repeatedly rub their skin, thus causing scratching skin lesions .
These skin lesions represent, for bacteria, a possible access route to the organism.
The entry of bacteria into the body can trigger an infection, the typical symptoms of which are: high fever, pus and acute pain.
Diagnosis
In general, for a correct diagnosis of eczema, physical examination and evaluation of the patient's medical history are essential and sometimes sufficient.
Doctors resort to more in-depth analyzes - such as allergy tests and skin biopsy - when doubts remain about the type of eczema.
Treatment
Each patient with eczema is a case in itself .
Therefore, a valid treatment for an individual could be completely useless for another subject and so on.
Eczema therapy includes the use of emollients and various medications, including:
- Corticosteroids for topical or oral use (NB: "topical use" means that the preparation in question must be applied directly to the affected area).
- Immunosuppressants with topical administration.
- Antibiotics with topical or oral administration.
- Antihistamines .
For some types of eczema, doctors may also prescribe some form of phototherapy (photochemotherapy, photodynamic therapy, etc.).
EMOLLIENT
All the preparations able to soften, moisten and make the superficial layers of the skin more emollient .
Clearly for topical use, emollients relieve skin rash disorders and help the skin restore its normal appearance.
CORTICOSTEROIDS
Corticosteroids are powerful anti-inflammatory drugs belonging to the steroid family.
If taken for long periods of time and / or in excessive doses, they can have serious side effects, such as: osteoporosis, diabetes, cataracts, hypertension or obesity.
Two corticosteroids particularly in use in the presence of eczema are hydrocortisone and clobetasol propionate .
The side effects of topical corticosteroids consist of: acne, increased hair growth, telangiectasia and thinning of the skin.
IMMUNOSUPPRESSANTS
Immunosuppressants are medicines that reduce the effectiveness of an organism's immune system.
Thanks to this property, they are able to alleviate the inflammatory response that eczema sets in motion.
As for the side effects, it is good to remember that taking immunosuppressants makes the body more fragile, increasing susceptibility to infections.
| More suitable immunosuppressants for eczema: | |
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ANTIBIOTICS
Doctors prescribe the use of antibiotics, only if some skin area, affected by eczema, has developed a bacterial infection.
ANTIHISTAMINES
Antihistamines are medicines that block the release of histamine, a compound produced by some cells of the body and released in the event of inflammation.
Doctors prescribe a cure based on antihistamines, when eczema causes intense itching and irritation.
An antihistamine widely used in the presence of dermatitis is diphenhydramine .
To learn more: Medications to cure Eczema »
Types
Doctors distinguish the various types of eczema into two broad categories: the category of common eczemas - to which belong the most popular types of eczema - and the category of non-common eczemas, which include the lesser known eczemas.
- The common eczemas are: atopic eczema, contact eczema, seborrheic eczema and asteatosic eczema.
- The non-common eczemas, on the other hand, are: dyshidrosis, discoid eczema, varicose eczema, herpetiform dermatitis, neurodermatitis, self-eczematisation, stasis dermatitis, perioral dermatitis and eczema due to particular morbid conditions (infections, lymphomas, etc.).
ATOPIC ECZEMA
Atopic eczema, or atopic dermatitis, is the most common type of eczema among humans.
According to doctors and experts in skin diseases, this would be an allergic disorder with a genetic-hereditary component.
Particularly widespread among children (but potentially able to arise at any age), atopic dermatitis mainly affects:
- Individuals suffering from asthma or hay fever.
- Individuals with a family history of eczema, asthma or hay fever (ie individuals with suffering relatives of one of these conditions).
- Individuals with some skin barrier defect.
Generally, the rash of atopic eczema involves itching, erythema, redness of the skin and vesicles.
By contact with soaps, rough clothing, some household chemicals and / or dust mites, the manifestations of atopic eczema mostly involve the face, hands, feet, the inside of the elbows and the back of the knees.
The most indicated treatments include: the use of emollients, the application of corticosteroids on the affected areas, the administration of immunosuppressants and antibiotics (if there are bacterial infections) and finally some photochemotherapy sessions.
To learn more: Atopic eczema symptoms
CONTACT ECZEMA
Contact eczema, or contact dermatitis, is an inflammatory condition of the skin that appears after contact with harmless substances for most people.
Contact dermatitis can be of two types: irritative contact dermatitis and allergic contact dermatitis.
- Irritative contact dermatitis results from the interaction (sometimes occasional, sometimes repetitive) with particularly powerful irritants, such as sodium lauryl sulfate .
- The allergic contact dermatitis, on the other hand, arises following the interaction with allergens (ie substances that in some individuals trigger an allergic reaction).
Some typical allergens that characterize contact dermatitis are: nickel, poison ivy and cosmetics containing the so-called balsam of Peru.
Based predominantly at the level of the hands, contact eczema causes a rash characterized by itching, swelling, dry skin and redness of the skin.
The most indicated treatments include: the application of emollients, the use of corticosteroids, the use of antihistamines and, only in the presence of bacterial infections, the intake of antibiotics.
In the presence of allergic contact dermatitis, doctors advise avoiding contact with any product or substance that contains the allergen.
SEBORRHEIC ECZEMA
Seborrheic eczema is a typical condition of the scalp, which in some cases can also affect the eyebrows, the sides of the nose, the anatomical area behind the ears, the groin and the center of the chest.
Seborrheic eczema causes a rash, characterized by the formation and loss of greasy scales. At the level of the scalp, these greasy scales take the generic name of dandruff .
The precise causes of seborrheic eczema still remain unknown. However, the researchers believe that the infections produced by the fungus Malassezia furfur are a possible factor favoring this type of dermatitis.
The most indicated treatments include: the use of detergents and shampoos based on salicylic acid, selenium, zinc or coal tar; the application of corticosteroids; and finally the intake of antifungal preparations.
To know more:
Seborrheic dermatitis symptoms
Seborrheic dermatitis drugs
ATEATOSIC ECZEMA
Asteatotic eczema, or xerotic eczema or xerosis, is a skin inflammation that causes, above all, hardening and dryness of the skin and, less frequently, itching.
It is typical of old age and is usually located at the level of the limbs and trunk.
pompholyx
Dyshidrosis, or dehydrotic eczema or pompholix, is a dermatitis that mainly affects the hands and feet.
Generally, it is responsible for a rash, characterized, in the initial phase, by blisters and itching and, later, by redness.
In many cases, dehydrosis has the characteristics of a chronic disorder.
The most effective treatments and remedies include: the administration of corticosteroid drugs, phototherapy (in particular photochemotherapy) and the application of wet / cold compresses on symptomatic areas.
ECZEMA DISCOIDE
The discoid eczema, or nummular eczema, is a dermatitis that causes oval or circular patches, of reddish-brown color, in various parts of the body.
The most affected anatomical sites are: the forearms, hands, feet, trunk and legs.
The precise factors triggering discoid eczema are unknown, although some clinical studies report the possible influence of the dry skin condition.
The most effective treatments include: the application of emollients, the administration of corticosteroids and the intake of antibiotics (if there is an infection).
ECZEMA FROM VARICOSAS
Stasis eczema, or venous dermatitis or varicose dermatitis, is an inflammation of the skin that people with problems of venous circulation at the level of the legs (varicose veins, reduced venous return to the heart, etc.) develop.
From totally unknown causes, stasis eczema causes a rash, characterized by redness, itching, scales and dark skin.
It is more common in people over the age of 50.
ECZEMA ERPETIFORME
The herpetiform eczema is a dermatitis that produces a rash, characterized by blisters and itching and symmetrical appearance.
The most affected anatomical areas are: arms, legs, knees and back.
For reasons still unknown, herpetiform eczema is particularly common among people with celiac disease.
neurodermatitis
Neurodermatitis is a particular eczema that appears in those who have a nervous habit of scratching in a certain area of the skin.
Generally, it causes itching and thickened skin.
To heal, the remedies consist of finding a way to avoid scratching and taking some anti-inflammatory drugs.
AUTO-ECZEMATIZZAZIONE
Self-eczematisation is a type of eczema that appears as a result of parasitic infestations or fungal, bacterial or viral infections.
Generally, the site of the rash is far from the place of infection.
By properly treating the infection that favors it, self-eczematisation is treatable with excellent results.
PERIORAL DERMATITIS
Perioral dermatitis is an eczema that causes a rash around the mouth.
Typical characteristics of this rash are: the presence of blisters, itching and burning.
Possible risk factors include: the use of fluoride-based toothpastes, the use of oral contraceptives, the application of some cosmetics, the use of some detergents, exposure to cold, etc.
Generally, doctors treat this type of eczema with immunosuppressants and antibiotics, and discouraging sun exposure.
