Atopic eczema involves skin inflammation with reddening, intense itching, dryness, blistering and scaling. Since not all cases can be associated to allergy, atopic eczema/dermatitis syndrome (AEDS) is the preferred term. This not a contagious condition but can persist with varying degrees of severity throughout a number of years.
AEDS typically starts with “cradle cap” among infants after the initial 3 months of life. As the baby becomes a toddler, the disease spreads to the face, exterior elbows and knee and the skin starts to ooze and crust. After some time, eczema develops on the hands, neck, inner elbows and behind the knees.
The skin becomes dry and scaly as a result of scratching and rubbing. Among adults, this can result to weeping, patches and itchy lumps. Fresh flare-ups often start without any evident symptoms except for increased itchiness that is followed by elevated red lumps.
It is important to note that these features can also occur in other skin issues. When confirming a diagnosis, the doctor will check for the following symptoms:
- Areas of skin displaying the typical appearance of eczema
- Early onset of symptoms of eczema
- Usual location of the affected areas
- Evidence of IgE-mediated reactions identified by a skin prick test or blood test.
- Family or personal history of IgE-mediated allergy diseases such as asthma, eczema and hay fever.
What are the causes?
- Abnormal immune and nervous system activity – some individuals with AEDS might have abnormal amounts of IgE antibody in the blood.
- Food allergy and intolerance – AEDS can be triggered and aggravated by certain foods among sensitive individuals.
- Skin barrier and bacteria – Once the skin is impaired, it can lead to the development of eczema.
- Aeroallergens – some individuals with IgE antibody variety of AEDS experience deterioration of the skin symptoms following exposure with airborne allergens.
- Psychological factors – the extended process of coping with chronic diseases among the individual with AEDS and their family can be considered as a source of stress. In addition, worsening of eczema has been shown to occur after emotionally stressful events.
Proper management of AEDS involves education, cooperation between the doctor as well as dealing with psychological issues if there are any. The treatment of symptoms includes frequent use of ointments or creams suitable to the skin type, oil baths and application of moisturizers.
The treatment of inflammation in acute cases typically includes antiseptics and topical steroids as well as wet-wrap dressings and oral antihistamines. If needed, topical antifungal treatment or oral antibiotics can be given. In some circumstances, there are non-steroidal immunosuppressant agents that can be applied topically that are readily available. Always bear in mind that the avoidance of allergens is vital.
Once the trigger factors are identified, they must be avoided. Avoidance measures can also help out such as eliminating specific foods from the diet, covering bedding in allergy-proof casing and removing pets from the house.