Eczema

Many factors contribute to the development of eczema, including genetic susceptibility, environmental factors, microbiome, and immune system dysregulation. The microbiome refers to the collection of microorganisms, such as bacteria, viruses, fungi, and their genetic material, that live on and inside the human body. These microorganisms play essential roles in human health and disease. Immune system dysregulation refers to a state where the immune system does not function properly or as expected. A family history of allergic diseases like hay fever or asthma increases the likelihood of a person developing eczema.

The symptoms of eczema, or atopic dermatitis, can vary in severity and may include the following:

• Itchy skin: Often the most noticeable and bothersome symptom, leading to scratching that can exacerbate (make worse) the condition.
• Red or brownish-gray patches: Commonly appearing on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees, and in infants, the face and scalp.
• Small, raised bumps: These may leak fluid and crust over when you scratch.
• Thickened, cracked, or scaly skin: Chronic scratching can lead to thickened areas of skin.
• Raw, sensitive, swollen skin from scratching: The skin may become more sensitive due to inflammation and irritation from scratching.

The severity and types of symptoms vary from person to person. Eczema may flare up and then subside for a time. It’s important to note that eczema can also lead to complications such as skin infections, especially if the skin is broken from excessive scratching.

Eczema, or atopic dermatitis, is typically diagnosed through a medical history review and physical examination. The process generally involves the following steps:

• Medical history: The doctor will inquire about your symptoms, duration, and family history of eczema or other allergic conditions like hay fever and asthma.
• Physical examination: The doctor examines the skin to observe the characteristic signs of eczema, such as rash, dryness, and areas of inflammation.
• Symptom pattern recognition: Eczema often presents in a specific pattern, especially in terms of the rash’s location and the age of the person. For instance, in infants, eczema typically appears on the face, while in older children and adults, it may be more common in the body’s creases.
• Ruling-out other conditions: Since other skin conditions can mimic the symptoms of eczema, your provider may need to rule out conditions like psoriasis, allergies, or fungal infections.
• Patch testing or allergy testing: In some cases, if the provider suspects a specific allergen might be triggering eczema flare-ups, he or she may recommend patch testing or other allergy tests.

There is no specific laboratory test for eczema. The diagnosis is based on your symptoms and medical history. In uncertain cases, a skin biopsy might be performed.

Eczema is not curable, but it is manageable through treatment. Traditional treatments involve:

• Oral anti-inflammatory medications
• Topical anti-inflammatory medications
• Moisturizers
• Trigger avoidance through lifestyle modifications
• Phototherapy or light therapy
• Immunosuppressants and short courses of steroids