Eczema, also known as dermatitis is a fairly common and widespread skin disorder, which manifests itself in the form of inflammation and rashes on the surface of the skin [1]. Eczema affects both males and females and can affect people of any age group, although it is observed to be more prevalent in young children and infants. Eczema can affect any part of the body and the signs and symptoms of the skin condition may vary with age groups as with the location of the disease on the surface of the body.

The exact cause of eczema is yet to be determined and it is believed to be a condition that is caused by a combination of genetic factors which are triggered by some specific environmental conditions. As such, the treatment measures of eczema are only limited to controlling the signs and symptoms of the disorder.

While eczema can prove to be a frustrating disease to suffer from as it causes a lot of irritation and scratching of the skin, it is not a serious or a life threatening condition. However, eczema is also associated with some complications such as the development of seasonal allergies such as hay fever or asthma and may also cause problems with the eye region. The signs and symptoms of eczema should be identified at the earliest in order to diagnose the disease and prescribe a proper course of treatment.

The treatment options for dermatitis or eczema can help alleviate the signs and symptoms of the disease [2]. Most of the common treatment options include medications and life style remedies while avoiding the exposure of the skin to allergens and irritants.

Eczema signs and symptoms in Infants and Children

Eczema is known to be more common in younger children. In infants and children, eczema may occur with differing degrees of severity and at different areas of the body depending upon the age of the child. Eczema flares are seen more commonly on the head, face or feet are in case of infants and young children as compared to adults.

In young babies or infants, the flares of eczema may occur more prominently on the forehead, cheeks or the scalp. Besides these areas, it may also affect other regions of the body except the diaper area of babies. For the children in their crawling stage that is in between six to twelve months, eczema may occur in its worst form in the knee and elbow regions. In these babies, eczema rashes are much more red and weepy in appearance.

In children of two years of age or above, the eczema rashes appear mostly dry with thickened skin. One may also notice lichen formation or prominent lines on the surface of the skin in these children. Such rashes are commonly distributed on the knees, the crease of the elbows, ankles, the wrists and the hands. One may also notice eczema flares around the eyelids as well as the mouth in case of toddlers.

In older children or adolescents, eczema occurs more commonly on the hands and forearms.

It has been observed that in cases of eczema occurring in children and young infants, most of the sufferers go on to develop some sort of seasonal allergy later on in life. Common examples of such allergies include hay fever and asthma.

Children who have a history of eczema or hay fever and asthma in the family are more likely to encounter the skin disease. It has also been observed that children born to younger mothers are less prone to contracting dermatitis than those born to older mothers. While the cause of eczema is still to be determined, studies have also reported that children of African American descent are more prone to encountering dermatitis than children of other races.

Eczema signs and symptoms in Adults

Eczema in adults may occur in different forms and in different degrees of severity across various locations on the body. Its appearance may vary, ranging from dryness and flakiness of the skin, representing a milder form of eczema, to the severe forms of the skin condition characterized by extreme irritation and redness of the skin. In the most severe cases, eczema may be characterized with cracking of the skin along with oozing of pus or yellow colored fluid from the vesicles on the surface of the skin.

Eczema bouts take place in intervals or episodes that may occur when the individual is exposed to certain triggering factors like stress, heat, irritants like dust, fibers etc. that may lead to itching, redness and inflamed rash formation. It is important for adults who have suffered from eczema to identify possible triggers and irritants which may cause the disease and avoid exposing the skin to these factors in the future.

Eczema signs and symptoms in Pregnant Women

Women who had suffered from eczema before pregnancy, eczema may worsen in most of the cases due to pregnancy hormones. Pregnancy may improve eczema in a few cases.

Women who had not suffered from eczema before their pregnancy, mild to severe symptoms may be seen in them. Mild eczema during pregnancy may be characterized by pink to red, dry and flaky skin along with itchiness. Severe eczema comprises of cracked and bleeding skin, prone to secondary infection. In pregnant females, eczema flares may be commonly seen on the hands, wrists, inside the elbows or the back of the knees. It may also be found on the other regions including the face and the neck.

Common signs and symptoms of Eczema

Some of the signs and symptoms of eczema are common regardless of the location of the rash on the body or the age group of the individual. Some of these signs and symptoms include the following:

  • Severe itching of the skin which proves to be more prominent at night
  • Appearance of reddish or brownish gray patches on the surface of the skin
  • Appearance of small and raised bumps on the surface of the skin which contain pus filled liquid
  • Dry, thick, scaly and cracked skin
  • Swollen and sensitive, raw skin

Factors which worsen symptoms of Eczema

There are certain factors which may prove to greatly worsen the signs and symptoms of eczema in individuals [3]. Some of these factors include:

  • Excessive dryness of the skin as caused by taking long and hot showers
  • Excessive scratching of the skin which damages and ruptures the skin tissue
  • Infection caused by bacteria and viruses
  • Taking up a lot of stress can reduce the immune function of the body and can prove to worsen dermatitis conditions
  • Excessive sweating can cause further irritation to the rashes on the skin surface
  • Sudden changes to the body heat, or sudden changes in humidity may also worsen the signs and symptoms of eczema
  • Some common cleaning items such as soaps, detergents and solvents contain chemicals which can irritate the skin surface
  • Wool, as present in blankets, carpets or clothing can also prove to irritate the surface of the skin
  • Pollen and dust are known to be irritants that can increase the intensity of an eczema flare
  • Pollution and smoke are also considered harmful to eczema conditions
  • Certain food items such as wheat, eggs, dairy products, soybeans, nuts and seeds may also contain allergens which can worsen the signs and symptoms of dermatitis

Complications of Eczema

Eczema is associated with a number of nasty complications which can prove to cause sufferers a great deal of discomfort [4]. Some of these complications include the following:

  • Eczema sufferers often go on to develop allergies such as hay fever and asthma later on in life
  • A chronic skin condition known as neurodermatitis, characterized by scaly, leathery and itchy skin may be developed if eczema sufferers scratch the skin surface excessively
  • Repeated scratching of the surface of the skin can cause the tissue of the skin to get ruptured and this increases the chances of an infection by certain bacteria and viruses
  • Eczema occurring around the eye region can cause severe itching and watering of the eyes and may further lead to the development of blepharitis or conjunctivitis
  • Some workers are exposed to a number of harsh chemicals as found in solvents, cleaners and detergents and these may prove to randomly cause a bout of irritant contact dermatitis
  • Contact dermatitis may also be induced by some specific allergens, including corticosteroid drugs
  • Excessive itching and scratching can greatly reduce the quality of life and can cause disruptions in everyday normal activities such as sleep cycles
  • Children diagnosed with eczema have also demonstrated some sort of correlation with the development of attention deficit hyperactivity disorder

Diagnosis of Eczema

There is no single test that is considered to be conclusive for dermatitis and more often than not, the condition is diagnosed through a visual inspection without the need of having to resort to a test in the lab. There are some other skin conditions which have signs and symptoms similar to those of dermatitis and in order to distinguish them, doctor often use the following tests:

  • Patch testing is used in order to find out which substances the skin surface is allergic to
  • Skin prick testing can be used to find out which specific allergens can cause skin infection
  • Supervised food challenges are used in order to determine possible allergic reactions to food

Eczema can be diagnosed by a physician or a dermatologist through a diagnosis of the family medical history of the individual and also by performing a clinical examination on the skin tissue of the patient. The medical history includes any history of the signs and symptoms of eczema in an individual in the past 12 months and also any cases of eczema, hay fever or asthma running in the family.

Diagnosis of eczema may also comprise of maintaining a diet diary in order to figure out the foods that may trigger eczema. Certain food items such as wheat, soybeans, eggs, dairy products, seeds and nuts may contain allergens which can cause a bout of eczema to flare up.

The clinical examination for eczema includes examining the skin for rashes and inflammation, often also checking for the presence of infection. Most medical practitioners are experienced enough to be able to identify eczema signs and symptoms through clinical examination alone.

Studies are also being carried out on blood tests carried out on eczema sufferers in order to determine the sensitivity, the tolerance and the allergy to food groups. However, these studies are still inconclusive and active research is being carried out in this field in order to determine the possible causes of the skin condition as also to find an effective method of cure for the disease.

It is important to diagnose the signs and symptoms of eczema at the earliest in order to prevent complications associated with the disease and also to reduce the duration of the course of the eczema flares. Diagnosis can also help in identifying the factors and the triggers of eczema, which proves to be of great help in preventing future attacks of the disease.

Eczema is not a life threatening condition and simple treatment remedies can help control the signs and symptoms of the disease [5]. It is important to always keep the skin nourished and moisturized and the skin should not be exposed to harsh conditions in order to prevent eczema. Even though the condition is not completely curable, different treatment methods and remedies can help different individuals manage their conditions effectively. Individual treatment plans may vary depending on the signs and symptoms of the disease, the severity of the disease, the current state of health of the individual, any other accompanying or underlying diseases and also on the age group of the individual. Applying topical creams can also prove to be effective to reduce eczema bouts. However, all types of eczema sufferers will always need to maintain lifelong care in order to avoid exposing the skin to potential allergens as recurring bouts of eczema are very common and are to be expected to occur.

 

References


[1] Dietary factors and the risk of psoriasis. Results of an Italian case-control study, Naldi L, Parazzini F, Peli L, Chatenoud L, Cainelli T; 134(1):101-106-1996-DOI: 10.1111/j.1365-2133.1996.tb07846, http://europepmc.org/abstract/MED/8745893


[2] Psoriasis,Beth Israel; 350(9074):349-353-1997-DOI: 10.1016/S0140-6736(97)052574, http://europepmc.org/abstract/MED/9251649


[3] Vegan proteins may reduce risk of cancer, obesity, and cardiovascular disease by promoting increased glucagon activity, McCarty MF; 53(6):459-485-1999-DOI: 10.1054/mehy.1999.0784, http://europepmc.org/abstract/MED/10687887


[4] Treatment of Staphylococcus aureus Colonization in Atopic Dermatitis Decreases Disease Severity, Jennifer T. Huang, Melissa Abrams; e808 -e814-May 1, 2009-DOI: 10.1542/peds.2008-2217, http://pediatrics.aappublications.org/content/123/5/e808.short


[5] Atopic Dermatitis,Hywel C. Williams; 352:2314-2324-June 2, 2005-DOI: 10.1056/NEJMcp042803,

http://www.nejm.org/doi/full/10.1056/NEJMcp042803