Balfour Dermatology - Eczema

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ECZEMA
Eczema is a chronic recurring intensely itchy inflammation of the skin usually
starting in early childhood. It is known as atopic eczema as well as atopic dermatitis.

WHO IS AFFECTED BY ECZEMA?
Eczema affects probably 10-15% of the population and is becoming more common for reasons that are not well understood. The frequency is variable throughout the world. Eczema is easily recognized by the dermatologist. Three quarters of the time, eczema presents itself in the first six months of life. The condition waxes and wanes over the years with frequent flare-ups. There are no specific tests available to confirm the diagnosis. The majority of cases have an increase in the serum Ig E level which is a sign of increased immunological activity.
WHAT DOES THE WORD ECZEMA MEAN?
Eczema, hay fever and asthma are grouped together in a complex known as atopy. The cause of eczema is not entirely understood. Genetic, immunological as well as skin barrier defects are important factors. External factors often influence the condition. The barrier function of the skin is less effective which allows more water loss from the skin. An increase in skin bacterial infections especially by staphylococcus aureus can be seen.
PSYCHOLOGICAL IMPACT OF ECZEMA:
The psychological impact of this disease is significant, especially feelings of embarrassment. Sleep disruption is common (80%) and 60% report the condition affecting their daily activities.
DIAGNOSIS OF ECZEMA:
Diagnosis of this condition, which has variable appearances, is dependent on a number of factors. The features or appearance in one person may be different from another. Skin in different locations in the same person may also have variable appearances which change according to the severity of eczema in that specific location
FEATURES IMPORTANT IN MAKING A DIAGNOSIS OF ECZEMA:
1. Itching
2. Dryness of the skin
3. Skin Inflammation
4. Secondary infection of the skin
5. Frequent flare-ups of eczema activity
6. Family history of eczema, hay fever or asthma
 Eczema is an itchy skin condition ... plus three or more of the following features:
- Involvement of skin in front of the elbows, behind the knees, the side of the neck or on the cheeks of children
- Personal history of asthma or hay fever, a history of atopic disease in first degree relatives in those under the age of 4 years
- General dry skin in the previous year
- Eczema present in the folds of skin in front or the elbows or behind the knees of on the face or outer aspects of the limbs in the under 4 year olds
- Eczema starting before the age of 2 years

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