Eczema: behind the name, multiple diseases

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What is this rash? Why does it itch so much? Is it going to cover my entire body? Eczema is a name we all know, but what is this disease, really?

Eczema regroups several skin diseases and can worry some people and with good reasons: a frequent cause for this disease is stress. But you should not really lose sleep over it. It is a very common skin condition that can disappear as quickly as it came.

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Skin with eczema
Skin with eczema – Image by Healthline

What is eczema, exactly?

As mentioned earlier, eczema (or dermatitis, in its medical denomination) regroups several skin diseases, all consequences of inflammation. The exact cause of eczema is unknown. Although inflammation can sometimes be quite severe, it usually focuses on a part of the body, causing the skin to turn red, rashy and itchy.

As mentioned earlier, eczema regroups different skin diseases and can therefore appear in many forms:

Allergic contact dermatitis

The name is pretty straighforward: this form of eczema is a direct allergic reaction to an allergen.

Allergens known to cause allergic contact dermatitis include:

  • local antibiotic creams
  • Balsam of Peru (which can appear in food, drinks, perfumes or pharmaceuticals
  • leather
  • gold (used in jewelries)
  • nickel (used in silverware, cooking utensils or jewelry)
  • topical steroids (used to treat psoriasis, for instance)

This form of exczema is very easy to diagnose, since it appears directly on the site of exposure to the allergen. For instance, if you are allergic to the gold in your bracelet, you will develop a rash around your wrist.

Irritant contact dermatitis

Very similar to allergic contact dermatitis, this skin disease differs by not being caused by an allergen, but by an irritant. Irritants can include:

  • detergents
  • acid
  • solvents
  • low humidity
  • plants

Atopic dermatitis

Although this form has a complicated name, it is rather easy to understand. In the case of atopic dermatitis, the skin reacts to an allergen (just like in the case of allergic contact dermatitis), but not in the area that is exposed to the allergen.

This means the skin will show all the symptoms of eczema (redness, itchiness and rash), but where it is not expected. The affected area can become hard or even ooze a clear fluid. This condition usually develops in childhood and can worsen over time.

Usually, atopic eczema affects mostly the inside of the knees or elbows during puberty and hands and feet during adulthood, but it can cover the whole body in severe cases or in the case of infants and young children.

Stasis dermatitis

Stasis means stagnation. So this form of eczema appears in areas of the body where blood stagnates because of insufficient veinous return.

Since this condition is most frequent in the legs, stasis dermatitis usually appears in the same area and can even be the first sign of insufficient veinous return.

The symptoms can be a little different from other forms of eczema: the skin usually appears brown (instead of red) and thin. It can seem weakened, almost paper-like in some places and can also be swollen around joints (like ankles and knees).

Also, it is frequent to also find sores, ulcers (holes) and pain.

What is the difference between eczema and psoriasis?

Although they can seem similar, both skin conditions are very different. For instance, in the case of psoriasis, itching is usually mild and easy to ignore, whereas it is very intense in the case of eczema. In fact, some patients afflicted with eczema have been observed to scratch their skin until it bleeds.

Also, their appearance is different: while psoriasis causes your skin to become red and scaly, it is also thickened and more inflamed. In the case of eczema, scaliness is rare and the skin does not usually thicken as much as in the case of psoriasis.

Finally, the location on which these diseases develop is also usually different. When eczema typically develops around joints or on your neck, psoriasis is more frequent on the back, the palm of the hand or the sole of the foot.

What causes eczema?

The exact cause for this skin condition is still unknown, but there are two main factors to eczema:

  • Environmental: just like asthma, psoriasis develops more frequently in patients living in an unclean environment. Exposure to dust, bacteria or pollution in your childhood increases the risks to develop this skin condition. Some studies have even linked eczema to house dust mites.
  • Genetic: although eczema is not a true genetic condition, some genes appear to play a role in developing eczema. For instance, twins are 50% more likely to get dermatitis if the other twin has already developed it. In some forms like atopic dermatitis, this can even increase up to 75%.

Researchers presume the cause of eczema to be a combination of these factors.

How is eczema diagnosed?

Eczema is a simple diagnosis for your MD and depends on skin examination. Mostly, your physician will try to eliminate other skin conditions like psoriasis or skin infections.

Although the diagnosis is based mostly on the patient’s history and physical examination, your MD can also prescribe a biopsy to ensure you do not suffer from another affliction.

Can eczema be cured?

At the moment, there is no cure to dermatitis and treatments aim at reducing symptoms.

Hygiene

Frequent bathing (once or more a day) is recommended for patients afflicted with eczema, to both moisturize the skin and clear it of potential irritants and allergens. Some doctors even advise their patients to dilute a small amount of bleach into their bath water.

Home

Increased home hygiene and house dust mite prevention are both at the core of lifestyle changes you will have to face in case of eczema.

Moisturizers

Emollients (creams that moisturize and soften your skin) are often useful against eczema, but you should be aware that their efficiency has not been clearly proven.

Medication

Topical creams

Topical (local) creams are the first-line of treatment. Most of them contain corticosteroids (like cortisone) and the strength of the molecule prescribed by your doctor will depend on the severity of your affliction.

Antihistamines

Antihistaminic drugs suppress allergic reactions. Therefore, these drugs are very efficient in case of allergic eczema (like atopic dermatitis or allergic contact dermatitis).

Immunosuppressants

Immunosuppressants are drugs that inhibit your immune system to lower its reaction. In the case of eczema, they slow down inflammation and are usually prescribed in the form of topical creams.

Conclusion

Eczema is a simple diagnosis for your MD and is relatively easy to treat with proper lifestyle changes and medication.

More importantly, it is of the utmost importance your MD differentiate it with other skin diseases like psoriasis or skin infections. So if your skin turns red and itchy, consult a physician or dermatologist.

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References:

  1. Eczema Signs and Symptoms 2. The Best Eczema Creams 3. Eczema Treatments 4. Types of Eczema 5. Eczema Causes 6. Eczema in Kids and Babies 7. Common Eczema Misconceptions 8. Eczema Home Remedies 9. Eczema Types and Symptoms 10. Eczema on Scalp 11. Shots for Eczema Treatment

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