Seborrheic Eczema

Two type of seborrheic eczema may be considered under the heding of seborrheic eczema.One is adult,most commonly seen in young and middle aged,the other is infantile variety which seborrheic eczema begin as early as the age of 6 weeks and eczema see under the age of 18 months.

ADULT SEBORRHEIC ECZEMA

Seborrheic eczema is one of the endogenous eczema and the subdivision is based solely on clinical grounds.couse of seborrheic eczema is unknown, but there is often a positive family history.In the past pyococcal infection of the skin was implicated as apossible couse, but the bacteria,if present are now thought to colonize the skin as a secondary manifestation of the disorder.Yeast organisms of the genus malassezia are now thought to play arole etiology of seborrheic eczema.
Site of sebborheic eczema are: head and neck, scalp, face, at the sides of the nose, cheeks, chin, eyelids,skin behind ear, eyebrows,presternal an interscapular area of the trunk, intertrigo, axila, umbilicus and the glans penis.

MORPHOLOGY OF THE LESSIONS

On the scalp seborrheic eczema is manifested by diffuse scaling, there is erythema,crusting and exudation. on nasolabial fold or pinna. on the trunk seborrheic eczema occurs predominantly in presternal the lesion are red and scaly.on axila the skin is red and some times macerated.

Treatment

Scalp:Mild seborrheic eczema with shampooing every 2-3 days.for treatment dendruff.If more severe can use salisilic acid 2% and 2%sulfur in aqueous cream BP.
Other area with topical corticosteroid preparations are the most effective treatment. Becouse the eczema tends to be moist, and in expose and visible area cream are often better and more acceptable than ointments.
Topical antifungal preparations it help for the face, there are preparation cortison and antifunggal.

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.