Eczema is an itchy inflammation of the skin associated to a varying degree with other features such as redness of affected areas of skin, generally dry skin, which is often thickened in the areas that have been scratched, lumps or blisters in affected areas and signs of superficial infection such as weeping or crusty deposits. The red, itchy, and flaky skin that appears in eczema is a result of the skin’s inflammatory response to physical or environmental irritants. Anybody can get eczema, although those with a family history will have a greater predisposition of developing the disease. There is currently no cure for this condition, although there are treatments that may help to alleviate the itchy symptoms.
Archive for December, 2006
Following are the various types of Eczema…
Atopic eczema : Atopic eczema is closely linked with asthma and hayfever. It can affect both children and adults. One of the most common symptoms of atopic eczema is its itchiness (or pruritis), which can be almost unbearable. Other symptoms include overall dryness of the skin, redness and inflammation. Constant scratching can also cause the skin to split, leaving it prone to infection. In infected eczema the skin may crack and weep. Treatments include emollients to maintain skin hydration and steroids to reduce inflammation.
Allergic contact dermatitis : Develops when the body’s immune system reacts against a substance in contact with the skin. The allergic reaction often develops over a period of time through repeated contact with the substance. For example, an allergic reaction may occur to nickel, which is often found in earrings, belt buckles and jeans buttons. Reactions can also occur after contact with other substances such as perfumes and rubber. In order to prevent repeated reactions it is best to prevent contact with anything that you know causes a rash.
Irritant contact dermatitis : This is a type of eczema caused by frequent contact with everyday substances, such as detergents and chemicals, which are irritating to the skin. It most commonly occurs on the hands of adults and can be prevented by avoiding the irritants and keeping the skin moisturised.
Infantile seborrhoeic eczema : A common condition affecting babies under one year old, the exact cause of which is unknown. Also referred to as cradle cap, it usually starts on the scalp or the nappy area and quickly spreads. Although this type of eczema looks unpleasant, it is not sore or itchy and does not cause the baby to feel uncomfortable or unwell. Normally this type of eczema will clear in just a few months, though the use of moisturising creams and bath oils can help to speed this along.
Adult seborrhoeic eczema : Characteristically affects adults between the ages of 20 and 40. It is usually seen on the scalp as mild dandruff, but can spread to the face, ears and chest. The skin becomes red, inflamed and starts to flake. The condition is believed to be caused by a yeast growth. If the condition becomes infected, treatment with an anti-fungal cream may be necessary.
Varicose eczema : Varicose eczema affects the lower legs of those in their middle to late years, being caused by poor circulation. Commonly the skin around the ankles is affected, becoming speckled, itchy and inflamed. Treatment is with emollients and steroid creams. If left untreated, the skin can break down, resulting in an ulcer.
Discoid eczema : Is usually found in adults and appears suddenly as a few coin shaped areas of red skin, normally on the trunk or lower legs. They become itchy and can weep fluid. Usually discoid eczema is treated with emollients (and steroid creams if necessary).
Symptoms typically begin during infancy. They include cracks behind the ears and a dry, itchy, scaly rash on the inside of the elbows, backs of the knees, cheeks and sometimes other body areas, or they can be small bumps or blisters. Weeping, oozing and crusting may suggest the presence of secondary infectionThe itch can be so intense that sufferers feel compelled to scratch until the skin bleeds. Infants often find relief by aggressively rubbing their faces against the cot mattress or any other hard surface.
Many things cause eczema. The commonest is a general allergic over sensitivity (atopy). This sort of eczema is known as atopic eczema, and it is linked with asthma and hayfever. That is, these conditions often run together in a family.
The other possible causes include:
* Infantile eczema which often affects young babies. This may lead to a patch below their chins, which gets wettest from dribbling, and may be associated with cradle cap.
* Contact with substances which irritate the skin chemically. This is caused by direct contact between the skin and the substance, which might be such things as detergents, soaps, diesel or engine oils, strong chemicals, cleaners etc.
* Contact with substances which the body has become allergic to. Commonly this involves nickel, rubbers etc. If a woman was sensitive to nickel in the past it would cause a reaction where the bra hooks and suspenders came near her skin, as these typically contained nickel. Plastics have helped to overcome this risk, but jewellery and watches are still a common cause. Suddenly people need to spend a bit more on their presents to you!
* Varicose veins can lead to a form of eczema affecting the lower legs. This is known as varicose or gravitational eczema. As well as treatment of the skin, it is important to improve the blood circulation in the legs, and for most people this includes wearing support stockings and staying active on your feet. Your doctor will discuss the options.
Eczema outbreaks can usually be avoided with some simple precautions. The following suggestions may help to reduce the severity and frequency of flare-ups:
- Moisturize frequently
- Avoid sudden changes in temperature or humidity
- Avoid sweating or overheating
- Reduce stress
- Avoid scratchy materials (e.g., wool or other irritants)
- Avoid harsh soaps, detergents, and solvents
- Avoid environmental factors that trigger allergies (e.g., pollens, molds, mites, and animal dander)
- Be aware of any foods that may cause an outbreak and avoid those foods
Psoriasis is a skin condition characterised by red areas on the skin surrounded by silver scaly patches in the affected areas. It is caused by excessive growth of the top layer of the skin (epidermis). The epidermis of a person affected by psoriasis is far more active than that of a normal person the rate of cell reproduction is much greater (about 3 times).The excessive growth of the skin is due to abnormal behavior of white blood cells(T cells), associated with the immune system. When an area of skin is affected by psoriasis, these cells act as though the skin were damaged or cut, and attempt to repair the skin. This is done by producing new skin cells, at a much faster rate than skin that is not damaged. Despite the appearance of severe trauma in the area of skin affected by psoriasis the skin is not damaged and can return to complete normality. The abnormal skin cell re-production results in the skin becoming red and inflamed as blood supply to the area increases. Finally the skin becomes thick and scaly with an excess dead skin which it cannot shed fast enough.
Although its causes are not fully understood, psoriasis is not contagious. Your chances of developing psoriasis can be influenced by a family history of the condition and/or by environmental triggers such as infections, sunburns, or medications. Recent research has identified genes that may lead some people to be more susceptible to psoriasis, but some people who are genetically predisposed may never develop the condition.
The most common symptoms of psoriasis are thick, red patches known as plaques, and dry, silvery scales. These appear most often on the scalp, face, elbows, knees, palms, and soles of the feet. About half the people who live with psoriasis also see changes in their toenails or fingernails; these may include pitting, discoloration, shape changes, or even loss of the entire nail.
Nearly one quarter of the population with psoriasis also experiences arthritic symptoms in their joints. This could be a distinct condition known as psoriatic arthritis.
Psoriasis may seem to be of only one type: the red, scaly, uncomfortable kind. But dermatologists know that there are several types of psoriasis discussed as follows:
Plaque psoriasis : About 80% of those who have psoriasis have this form. It is characterized by raised, inflamed, red lesions covered by a silvery white scale. It is typically found on the elbows, knees, scalp and lower back, although it can occur on any area of the skin.
Inverse psoriasis : Inverse psoriasis is found in the armpits, groin, under the breasts, and in other skin folds around the genitals and the buttocks. This type of psoriasis first shows up as lesions that are very red and usually lack the scale associated with plaque psoriasis. It may appear smooth and shiny. Inverse psoriasis is particularly subject to irritation from rubbing and sweating because of its location in skin folds and tender areas.
Erythrodermic psoriasis : Also known as exfoliative psoriasis, this is a form of psoriasis that covers almost the entire body. It is characterized by severe redness and scaling, which is often accompanied by itching and pain. Because symptoms are so widespread over the body, this form can be extremely serious.
Guttate psoriasis : This often starts in childhood or young adulthood and resembles small, red, individual spots on the skin that are not normally as thick or as crusty as lesions of plaque psoriasis. This form of psoriasis may resolve on its own, occasionally leaving a person free of further outbreaks, or it may clear for a time only to reappear later as patches of plaque psoriasis.
Pustular psoriasis : Primarily seen in adults, pustular psoriasis is characterized by white pustules (blisters of noninfectious pus) surrounded by red skin. It is not an infection, nor is it contagious. It may be localized to certain areas of the body or can be generalized, covering most of the body. It tends to go in a cycle: reddening of the skin followed by formation of pustules and scaling.
Palmo Plantar Psoriasis : Palmo Plantar Psoriasis or Palmoplantar Pustulosis (“PPP”) is normally found on the palms of the hands and/or the soles of the feet. Unlike plaque psoriasis, there are no red, scaly lesions, rather a mass of weeping, cracked areas which look like tiny, yellowish blisters. These can be very painful and sore and look “infected”, even though there is no actual infection present within the pustules.
Psoriatic arthritis : About 10 percent of the people who have psoriasis will develop a form of arthritis called psoriatic arthritis. This causes inflammation and swelling in the hands, feet or in larger joints such as the knees, hips, elbows and the spine. It may cause stiffness, pain and joint damage.
Nail psoriasis : Psoriasis can affect toenails and fingernails. It usually appears as pits in the nails and the nails may change to a yellowish colour and become thick or crumble easily. They may also be surrounded by inflammation. In some cases the nail may break away from the nail bed.
Scalp psoriasis : Scalp psoriasis affects at least half of all people who have psoriasis. Raised, inflamed lesions covered with silvery white scales will develop on the scalp and particularly along the hair margins.
While there is no cure for psoriasis, many treatments are available to help reduce or eliminate the symptoms and rash associated with the disease. Because various forms of psoriasis exist and the disease affects everyone differently, no single treatment works best for everyone. Doctors who specialize in treating skin conditions, known as dermatologists, may need to be consulted to help decide the best treatment.
Goals of treatment for psoriasis include clearing up the present psoriatic rash and preventing new flare-ups of the rash. Finding the most effective therapy with the fewest side effects is paramount. To accomplish these goals, treatments for psoriasis include topical medications, sunlight or artificial UV light therapy (also called phototherapy), and oral or injectable medications. Sometimes a combination of these treatments may be used. Topical medications and sunlight therapy have the least occurrence of side effects and are generally useful for mild forms of psoriasis. Artificial UV light therapy and oral or injectable medications are reserved for more moderate to severe cases of psoriasis and may have a higher occurrence of side effects. The type of psoriasis and the severity of the psoriasis will help the doctor determine the best treatment approach.
Acne is a skin condition that occurs due to the overproduction of oil by the oil glands of the skin. The oil that normally lubricates the skin gets trapped in blocked oil ducts and results in what we know as pimples, blackheads, and whiteheads on the surface of skin. Sometimes it also includes deeper skin lesions that are called cysts.
- Pimples are small skin swellings that sometimes contain pus.
- Blackheads are dark formations on the skin due to an accumulated mixture of oil and cells in a blocked skin pore.
- Whiteheads are small flesh-or white-colored bumps due to skin pore blockage.
- Cysts are closed sacs beneath the skin or deeper that contain fluid or semisolid substances.
The areas of the skin that are most susceptible to acne are those areas that contain the largest number of oil glands. For example, it is estimated that there are 2,000 oil glands per square inch on the forehead alone. The face, chest, shoulders, and back are the areas with the highest population of oil glands.
Almost all teenagers get acne at one time or another. You haven’t done anything to cause your acne. It’s not your fault if you have it. Pimples are caused when oil ducts in the skin get plugged up and then burst, causing redness and swelling. Although there are many myths about acne, the following are the three main factors that cause it.
Hormones: When you begin puberty, certain hormones, called androgens, increase in both males and females. These hormones trigger oil ducts on the face, back and upper chest to begin producing oil. This can cause acne in some people.
Heredity: If other members of your family had acne as teenagers, there may be a chance that you’ve inherited a tendency toward getting acne as well.
Plugged oil ducts: If you are prone to acne, the cells that line the oil ducts in your skin tend to get larger and produce more oil, and the ducts get plugged. This traps the oil and leads to the formation of blackheads or whiteheads. The plugged ducts allow germs in the skin to multiply and produce chemicals that cause redness and swelling. This is why simple blackheads and whiteheads may turn red and bumpy and turn into the pimples of acne.
There is not much you can do about heredity, so your best control efforts are those that keep the oil ducts unplugged.
Acne is often treated by dermatologists (doctors who specialize in skin problems). These doctors treat all kinds of acne, particularly severe cases. Doctors who are general or family practitioners, pediatricians, or internists may treat patients with milder cases of acne.
The goals of treatment are to heal existing lesions, stop new lesions from forming, prevent scarring, and minimize the psychological stress and embarrassment caused by this disease. Drug treatment1 is aimed at reducing several problems that play a part in causing acne:
- Abnormal clumping of cells in the follicles
- Increased oil production
Depending on the extent of the problem, the doctor may recommend one of several over-the-counter (OTC) medicines and/or prescription medicines. Some of these medicines may be topical (applied to the skin), and others may be oral (taken by mouth). The doctor may suggest using more than one topical medicine or combining oral and topical medicines.