Eczema

The symptoms of eczema, also known as atopic dermatitis, can vary in severity and appearance. Common symptoms include:

• Itchy skin: Often the most noticeable symptom, leading to scratching that can exacerbate the condition.
• Red, scaly patches: These commonly appear on the bends of the elbows and knees, hands, neck, and face.
• Fluid filled bumps: Small, raised bumps that may leak fluid and crust over when scratched.
• Thickened, rough, cracked skin: This occurs from chronic scratching, which can lead to toughened, itchy areas of skin.
• Raw, sensitive, swollen skin: Prolonged scratching can cause the skin to become more irritated and inflamed.

Symptoms can flare up periodically and then subside. In some cases, eczema can lead to complications, such as skin infections, especially when the skin is broken due to excessive scratching.

The causes of eczema are multifactorial and include genetic predisposition, environmental influences, microbiome imbalances, and immune system dysregulation. The microbiome refers to the diverse community of microorganisms, such as bacteria, viruses, and fungi, that live on and within the human body. These microorganisms play crucial roles in maintaining health. Immune system dysregulation occurs when the body’s immune response is not functioning correctly, leading to excessive inflammation. A family history of allergic conditions, such as hay fever or asthma, increases the likelihood of developing eczema.

• Dry skin
• Cool, dry climates
• Excessively hot, long, or frequent showers/baths
• Exposure to allergens or irritants, such as fragrances
• Stress

Eczema is typically diagnosed through a combination of medical history and a physical examination. The process involves:

• Medical history: The dermatologist will ask about your symptoms, duration, and any family history of eczema or allergic conditions like asthma or hay fever.
• Physical examination: The dermatologist will examine your skin for signs of eczema, such as rash, dryness, and inflammation.
• Symptom pattern recognition: Eczema often presents in characteristic patterns
• Ruling out other conditions: Since other skin conditions may resemble eczema, your provider may need to rule out other issues, such as psoriasis or fungal infections.
• Patch or allergy testing: In some cases, if a specific allergen is suspected of triggering flare-ups, your provider may recommend patch testing.

There is no specific laboratory test for eczema; diagnosis is based on clinical evaluation. In uncertain cases, a skin biopsy may be performed to confirm the diagnosis.

Although there is no cure for eczema, it can be effectively managed through various treatments, including:

• Moisturizers to maintain skin hydration and barrier function.
• Trigger avoidance through lifestyle modifications, such as avoiding allergens or irritants.
• Topical anti-inflammatory medications such as corticosteroids or calcineurin inhibitors.
• For more severe cases, oral anti-inflammatory medication, injectable biologic medications, or phototherapy (light therapy).