Medical Dermatology: Eczema (Dermatitis)

Eczema (Dermatitis)

Eczema refers to the condition where the skin is itchy, wet and can be infected with bacteria. It can occur due to various factors, the most common being dryness of skin.

Atopic Eczema (Atopic dermatitis) :

This is a specific condition that usually starts in the childhood. It is now being seen more commonly especially in the affluent classes. A patient of atopic dermatitis has persistent dry skin all over body which tends to get worse in dry winter months. The condition begins with areas of redness that are very itchy and can often get infected leading to pain and sometimes fever. The areas of body commonly affected are face and body in infants, elbow and knee folds and other body folds in young children. As the child grows up it gets better and remains limited to either hands or legs. The disease has flare-ups brought on by changes in surroundings and seasons.

Treatment involves regular and intensive moisturizing of skin. The affected areas need treating with steroid and other creams. Severe cases are treated with oral medications like steroids, ciclosporin or azathioprine and phototherapy.

Gravitational eczema (Stasis dermatitis, Venous eczema):

One of the commoner skin conditions that I get to see in the clinic so often in the elderly and overweight population. It occurs more commonly after hip and knees replacement surgeries. The condition arises from the stagnation of blood in the legs that causes an irritation in the skin due to the deposition of blood products. This can make the skin go red, itchy and wet in localized areas on the legs and arounsd the ankles.

The usual treatment includes steroid and antibiotic creams and compression garments to reduce the stagnation of blood. Some leg muscle exercises also help.

Allergic contact dermatitis

The skin can react to metals, rubber and many other agents when it comes in contact with them. This presents as a patch of eczema at the site of contact. The commonest example is that of ear lobe eczema following use of artificial earrings made of white metal (contains nickel).

The condition can be confirmed with a “Patch Test” to determine the exact cause of allergic reaction. It is advised to avoid the incriminating agent so as to prevent recurrence of the condition.

Nappy Rash (Diaper Dermatitis)

As the name suggests, it occurs in babies who are in nappies for long hours. The prolonged contact of the skin with the soiled nappy can lead to an irritant reaction. It appears as red, oozing areas at the site of nappy contact.

The child needs to have frequent nappy change after soiling it everytime. Inaddition, it helps to use a barrier cream to protect the skin from coming in contact. The acute phase is treated with steroid and antibiotic creams.