Eczema is a chronic inflammatory skin condition characterized by dryness, itching, redness, cracking, and recurrent flare-ups. It encompasses a group of disorders that disrupt the skin barrier, leading to sensitivity and vulnerability to irritants or allergens. Below is a detailed overview of its symptoms, types, and management strategies:
Dry, scaly skin with visible cracks or fissures.
Intense itching (pruritus), often worsening at night.
Red or inflamed patches of skin.
Blisters or oozing (in acute phases).
Lichenification (thickened, leathery skin due to chronic scratching).
Atopic Dermatitis:
Most common type, linked to genetic predisposition and immune dysfunction.
Often begins in childhood and coexists with asthma/allergic rhinitis ("atopic triad").
Irritant Contact Dermatitis:
Caused by repeated exposure to harsh substances (e.g., detergents, solvents).
Allergic Contact Dermatitis:
Delayed hypersensitivity reaction to allergens (e.g., nickel, fragrances, latex).
Seborrheic Dermatitis:
Affects oily areas (scalp, face) with yellow, greasy scales.
Nummular Eczema:
Coin-shaped, itchy plaques often triggered by dry skin or injury.
Stasis Dermatitis:
Occurs in lower legs due to poor circulation (common in venous insufficiency).
Dyshidrotic Eczema:
Small, itchy blisters on hands/feet, often linked to stress or sweating.
1. Daily Skincare:
Moisturizers: Fragrance-free emollients (e.g., ceramide-based creams) to restore the skin barrier.
Gentle Cleansers: Avoid soaps with sulfates or alcohol.
2. Topical Therapies:
Corticosteroids: Reduce inflammation during flare-ups (short-term use).
Calcineurin Inhibitors (e.g., tacrolimus, pimecrolimus): For sensitive areas (face, eyelids).
Crisaborole: Non-steroidal anti-inflammatory ointment.
3. Systemic Treatments:
Oral Antihistamines: Relieve severe itching (e.g., cetirizine, fexofenadine).
Immunosuppressants (e.g., cyclosporine, methotrexate): For severe, refractory cases.
Biologics (e.g., dupilumab): Target immune pathways (IL-4/IL-13) in moderate-severe atopic dermatitis.
4. Trigger Avoidance:
Identify and eliminate irritants/allergens (patch testing for contact dermatitis).
Manage stress, humidity, and temperature extremes.
5. Phototherapy:
Narrowband UVB to reduce inflammation and itching.
6. Advanced Care:
Wet Wrap Therapy: Enhances topical medication absorption.
Biologic Therapies: For patients unresponsive to conventional treatments.
Accurate diagnosis to distinguish eczema from psoriasis, fungal infections, or scabies.
Personalized plans to address root causes (e.g., allergy testing for contact dermatitis).
Prevention of complications like infections (e.g., staph, herpes).