Eczema

Eczema most commonly refers to a hereditary skin condition of atopic dermatitis. Atopic dermatitis is an autosomal dominant disorder, i.e. tends to run in families from one generation to the other,  and commonly starts in childhood.

It is characterized by itchy red rashes on the face, trunk, arms and legs. In older individuals, the rash is frequently located in the flexures (where elbows and knees bend).

Accentuation of skin lines or lichenification and post-inflammatory hyperpigmentation or brown spots of the skin result from chronic inflammation and scratching in eczema.  In dark-skinned individuals, lesions may appear lighter or hypopigmented instead of red in color. There is a personal or family history of atopy such as hayfever, asthma or eczema. Atopic dermatitis is chronic and relapsing, although majority grow out of it by puberty. Recent evidence points to a defective skin barrier in atopic dermatitis, increasing transepidermal water loss through the skin and permeability to allergens, irritants and microbes. This mechanism leads to a constant process of subclinical or subvisible inflammation in atopic skin.  Hence, daily bathing and judicious use of moisturizers are keys to replenish hydration of the skin and restore skin barrier. Addressing contact allergy, including potential food allergens in recalcitrant or resistant cases, is important. Avoidance of skin irritation, such as the use of harsh soaps and detergents, is necessary. Early treatment of subclinical inflammation through preventive maintenance therapy with topical calcineurin inhibitors and control of acute flares with short pulses of topical corticosteroids will obviate complications such as severe generalized skin eruptions, secondary bacterial and viral infections and potential risk of lymphoma in longstanding uncontrolled eczema.

There are other confounding forms of eczema including from etiologies such as contact allergy, irritation, skin dryness, stasis, seborrhea. It is best to visit your physician or seek a referral to a dermatologist for accurate diagnosis and appropriate management of your skin condition.