Atopic Eczema

Atopic Eczema is commonly in infancy, and thus the term infantile eczema is used some authorities synonymously with atopic eczema. Atopic eczema is also reffered to as flextural eczema as the flexor aspects of the limbs are commonly affected. it should however,be remembered that atopic eczema can accur in adults and involve any part of skin.
The etiology of atopic eczema is multifactorial.Genetic factors are involved and there is a strong association with hay fever and asthma.

The possible abnormalities due to genetic factors are:
A defect in the stratum corneum (the skin barrier) leading to dryness of the skin and easier acces for chemical irritants and bacteria to penetrate into the skin.

A T helper cell type 2 cytokine response by infiltrating T lymposites.

Increased immunolglobulin E (IgE) pdoduction

Abnormality of the IgE receptor

impared response by the innate immune system.

The environmentals factors that may play a role in the etiology of atopic eczema include:

1. Pollution which has increased during the past 50 years
2. Micro organisms on the surface of the skin particularly staphylococcus aureus: in estabilished atopic eczema lesions, S aureus can be isolated in over 90% of patients
3. Lack of infective conditions in early life (the hygiene hypothesis)
4. Dietary and aero allergens : role of external allergens is difficult to establish with certainly becouse there are no reliable test.

Age incidence:
Atopic eczema is not present at birt and usually does not occur before the age of 3 months. common time of onset is during the first second years of life, although it may present for the first time later in childhood and rarely in adults.

Type of lesion
The typical physical sign are erythema, scalling and thickening of the skin. The features of eczema i.e. crusting and weeping, are not common but may accur, blisters are rare. Atopic eczema is very irritating condition and excoriations with bleeding are frequently seen. May also present with small fine papules on the trunk in addition to the more typical lesions described above.
Becouse of the excoriations and since, as in the most skin disorders, the protective function of the skin is lost,secondary bacterial infection is not uncommon. such infection may present as pustules or purulent custed areas.

Atopic eczema is assosiated with asthma and hay fever.The tree disorders together are referred to as the atopic syndrome,the atopic eczema syndrome is genetically conferred and there is frequently a positive family history of one of three complaints when a child with atopic eczema is seen for the first time.

Management and treatment: Topical treatment with steroids,topical pimecrolimus and tacrolimus safe for long term, emollients,topical antibiotics and antiseptics,sistemic therapy with: antihistamin,antibiotics,steroid. Phototherapy has been known for many years that sunlight helps chronic atopic aczema.

Skin Eczema

ECZEMA

Your skin child is suffering from Eczema commonly known as infantile/childhood eczema.What is skin infantile/childhood eczema ?
Skin whit Eczema is chronic,recurrent,allergic skin condition which manifest as redness, tiny,raised skin lesions,acompanionied by oozing and crusting.
The child may have associated allergy manifestations else when in the body, like running nose,conjunctivitis,bronchial astma etc.

• Eczema in one of more of family members may be affected by similar kind of allergic problem.
• Eczema can start at any age, but most of the cases start during the firs few months of ife.
• The skin of eczema children is very dry
• The breast fed infants have decreased chance of getting the eczema, but if they have it, the severity is lesser than the formula fed infants.

Precipitating or aggravating factor:
One or more of following factors may be responsible for causing eczema

1. House dust mites:found in the house dust,carpets,curtains etc.
2. Allergens in the air:pollens, mold, human or animal dande etc.
3. Food products: commonly seen with eggs, milk products, sheel fish, peauts,cornstarch etc.
4. Infections: Bancterial or fungal infections:Vice versa, the eczema children are more prone to get bacterial or fungal infections.
5. Clothes: woolens, nylons ets, by irritating the skin.
6. Stress.
7. Climate: heat/cold.

In majority of the patiens, the eczema improves or cleans by the age 5 years. Few may have aprolonged course

Instructions for care of skin Child with Eczema:
Since the conditions is chronic and recurrent, graet patiens is required by the parents. The treatment can improve the symptoms but can not eradicate the disease at once.

1. Try if possible to find out the provocative factors in your child, so that the precautions can be taken against them e g:Food products,Seasonal variations,House dust,Infections,Temperature,Stress.
2. Breast feeding is to be encouraged for the high risk infants (When there is a strong history of allergies in the family).
3. Avoid food products which have been observed to precipitate or aggravate eczema.
4. Frequent vacuuming of the carpets, furniture, mattresses, and laundering of linens to control the house dust mites is important.
5. Gentle skin care and local hygiene:dry skin predisposes to more itching and and this might lead to worsening of the eczema thus the care skin includes:
6. Use of gentle soaps or cleaners and frequent use of bath oils and moisturizers.
7. Avoid the frequent bathing, swimming etc,once daily bath with tepid water is sufficient
8. Avoid vigorous rubbing of the skin, pat dry the skin after a bath soon followed by a moisturizer.
9. Avoid the use of strong soaps,astringents,perfumes etc,ditrectly on the eczema skin.
10. Cotton cloting to be preferred and avoid the direct contact with woolens, nylons etc.
11. Avoid exposure to extremes of the temperature and a heavy exercise.
12. Use the treatment carefully and judiciously as advised by the dermatologist.
13. A regular follow up with your doctor is mandatory
14. For vaccination,consult your doctor
15. Relaxation activities and psychotherapy to the child is impotant in order to void the stress.