Eczema : Symptom, Cause, Diagnosis, Treatment And Type

Eczema (Dermatitis) is the skin inflammation.It is not contagious..It may get better or worse over time.People who have eczema may develop ashma and hay fever.It is often a long-lasting disease.Eczema affects babies, children and adults.Eczema occurs about three times more frequently in individuals with celiac disease.The symptoms of every type of eczema tend to appear in different area of skin.The cause of eczema is unknown.People with eczema should not get the smallpox vaccination due to risk of developing eczema vaccinatum, a potentially severe and sometimes fatal complication.

Mild eczema may be treated by compresses composed of tepid water followed by room air evaporation.Chronic eczema can be cured by applying water followed by an emollient such as lotion or moisturizing cream.Acute eczema treatment needs repeated cycles of application of dilute aqueous solutions followed by evaporation.Emollient used for eczema to be bland and non perfumed.


Symptoms of Eczema :

• Itchiness
• Red skin
• Small blisters
• Swelling
• Dry skin
• Thickened skin on the hand, neck, face, legs or anywhere.In children are in the inner creases of the knees and elbows
• Dry patches of the skin and open sores with crusts may develop and get infected if Eczema is scratched
• Skin lesions with sometimes oozing and scarring

Causes of Eczema

I Enviromental factors :

• Changes in climate such as hot and cold temperature
• Allergens such as pollens, mites, dust, pets, mold
• Irritans like detergens, soaps, disinfectants, shampoos
• Pollution
• Foods such as eggs, seeds, wheat, nuts, dairy products, soy products
• Microbes such as virus, fungi, bacteria of Staphylococcus aureus
• Diet
• Hormones such as menstrual cycle, pregnancy
• Stress

II. Genetic Factors
Three new genetic variants associated with eczema :

• OVOL1
• ACTL9
• IL4-KIF3A

Diagnosis of Eczema

To diagnose eczema can be done by some tests or procedures :

• Medical history of a patient is information gained by a physician by asking specific questions of patient condition.
• Physical Examination is the process by which a medical professional investigates the body of a patient for disease signs.
• Patch Test is a method used to determine whether a specific substance cause allergic inflammation of a patient's skin.
• Skin Prick Test is to identify allergies to pet dander, dust, pollen, foods or dust mites.
• Blood Test is to determine a link between food and illness.
• Skin Biopsy is a procedure in which a sample of skin tissue is removed, processed and examined under a microscope.

Treatment of Eczema

I. Use Moisturizers
Moisturizers agents (Emollients) can be applied at least once or twice a day.It is beter to use oilier formulations.


II. Medicines

• Hydrocortisone helps mild to moderate eczema
• Clobetasol Propionate helps severe eczema
• Antihistamines relieves the symptoms of eczema
• Corticosteroids can be taken if other treatments do not work
• Ultraviolet Light Therapy helps the severe condition of skin
• Azathioprine, Cyclosprine or Methotrexate work on immune system
• Topical Immunosuppressants, such as Pimecrolimus (Elidel) and Tacrolimus (Protopic) treat eczema by controlling inflammation and reducing the immune system reactions.They are used for a short time.According to FDA, Children under two years old cannot use the prescription creams.
• Prescription-Strength Moisturizers support the skin's barrier.
• Phototherapy is to treat mild to moderate eczema
• Probiotic is to prevent eczema

WAO (World Allergy Organization) recommend the use of probiotic for :

• Infants at high risk of developing allergy
• Women in pregnancy at high risk for having an allergic child
• Women in breasfeeding at high risk of develoving allergy

Types of Eczema 

 Common Types Of Eczema

1. Atopic Eczema

Atopic Eczema is an allergic disease believed to have a heriditary component and frequently runs in families whose members also have asthma.The symptoms of atopic eczema vary from person to person and the age of the person.Symptoms of Atopic Eczema are Itchy rash on head, scalp, neck, behind knees, buttock and inside of elbows.Atopic eczema usually manifests itself in infants with dry and scaly patches appearing on the skin.

The Symptoms of Atopic Eczema for Infant

• Rashes on scalp and neck
• Rashes bubble up before weeping fluid
• Extreme itchiness leads to sleeping problem.Rubbing and scratching continuously can cause skin infections

The Symptoms of Atopic Eczema for Children the age of two to Puberty

• Rashes behind the creases of elbows or knees, the crease between buttock and legs, on the neck, wrists and ankles
• Rashes become bumpy, like goosebumps
• Rashes can lighten or darken in color
• Lichenification is thickened rashes that develop knots and a permanent itch

The Symptoms of Atopic Eczema for Adult

• Rashes in the creases of elbows or knees or nape of neck
• The body is covered much rashes
• Dry skin
• Rashes on neck, face and around the eyes prominently
• Itchiness permanently
• Scaly skin
• Skin infections

Treatment of Atopic Eczema

• Avoid irritants to the skin and triggers, such as soap, bubble bath, detergent, dust, pollen, dander, milk, eggs, nuts, soya, wheat and fish
• Using moisturizers or emollients
• Using steroid cream and ointments (topical steroids)
• Tar shampoos is to lift scale from affected scalp
• Antihistamine is to ease itch
• Tacrolimus ointment and Pimecrolimus cream are to reduce inflammation

2. Contact Eczema

Contact Eczema has two types :

• Allergic results from a delayed reaction to an allergen, such as nickel, poison Ivy, Balsam of Peru.
• Irritant results from direct reaction to a detergent, such as sodium lauryl sulfate

3. Xerotic Eczema ( Asteototic Eczema, Pruritus Hiemalis, Winter Itch, Craquelatum or Craquele)

Xerotic Eczema is dry skin that becomes so serious.It affects limbs and trunk.It can worsen in dry winter weather.

4. Seborrheic Eczema

Seborrheic Eczema is a condition that is closely related to dandruff.It is curable.It causes dry or greasy peeling of the scalp, eyebrows, face and trunk.Seborrheic Eczema is called craddle cap in infants.Craddle cap is a thick, yellow, crusty scalp rash.It is often accompanied by a diaper rash.It seems related to lack of biotin.

Symptoms of Seborrheic Eczema

• Appearing gradually
• Dry or greasy scaling of the scalp (dandruff)
• Hair loss
• Pimples along the hairline, behind the ears, on the eyebrows, on the bridge of the nose, around the nose, on the upper back and on the chest in severe case
• Having a thick and yellowish scalp rash in newborn

Less Common Types Of Eczema

5. Dyshidrosis (Dyshidrotic Eczema, Pompholyx, Vesicular Palmoplantar Eczema)

Dyshidrotic Eczema occurs on palms, soles, sides of fingers and side of toes.Vesicles are tiny opaque bumps.Vesicles are thickening and cracks accompanied by itching, which gets worse at night.A common type of hand eczema, it worsens  in warm weather.

6. Discoid Eczema (Nummular Eczema, Microbial Eczema, Exudative Eczema)

Discoid Eczema condition tends to come and go.Its cause is unclear.It worsens in winter.

The characteristics of discoid eczema 

• Round spots of oozing or dry rash
• Clear boundaries
• Occuring on lower legs

7. Venous Eczema (Stasis Eczema, Varicose Eczema, Gravitational Eczema) 

Venous Eczema occurs in people with impaired circulation, varicose veins and dedema.It is common in ankle area of people over 50.

Symptoms of Venous Eczema :

• Redness
• Scaling
• Darkening of the skin
• Itching

8. Neurodermatitis (Lichen Simplex, Chronicus)
Neurodermatitis is an itchy area of thickened, pigmented eczema patch that results from habitual rubbing and scratching.It usually has just one spot.

9.  Dermatitis Herpetiformis (Duhring's disease)

Dermatitis Herpetiformis is typically symmetrical rash on arms, thighs, knees and back.It tends to get worse at night.It causes itchy intensely.

Symptoms of Dermatitis Herpetiformis

• itching
• Redness
• Stinging
• A burning sensation
• Having papules and vesicles
• Having small red bumps
• Symmetrically grouped on the upper or lower back, buttocks, elbows, knees, shoulders, scalp and neck.
• Rash inside the mouth or near the hairline

10. Autoeczematization
Autoeczematization is an eczematous reaction to an infection with parasites, fungi, bacteria or viruses.Its appearance varies depending on the cause.

11. Eczema Herpeticum (Vaccinatum)Eczema Herpeticum is overlaid by viral infections.


Some ways for people with Eczema to support the health of skin and to alleviate the symptoms :

• Take warm bath regularly
• Use mild soap or a non-soap cleanser when washing
• Dry skin with a towel without rubbing it after bathing or dry skin with air
• Apply moisturizer within three minutes of bathing to lock in moisture
• Moisturize every day
• Use a humidifier in dry or cold weather
• Avoid rapid changes of temperature and activities that make sweat
• Avoid rough, scratchy fibers and tight-fitting clothing or wear cotton or soft fabrics
• Prevent scratching from breaking skin with keep fingernails short
• Wear gloves for work
• Manage stress