Eczema Classification and external resources
Typical, mild dermatitis
ICD-10	L20.-L30.
ICD-9	692
OMIM	603165
DiseasesDB	4113
MedlinePlus	000853
eMedicine	Derm/38  Ped/2567

Eczema (from Greek έκζεμα) is a form of dermatitis, or inflammation of the upper layers of the skin. The term eczema is broadly applied to a range of persistent skin conditions. These include dryness and recurring skin rashes which are characterized by one or more of these symptoms: redness, skin edema (swelling), itching and dryness, crusting, flaking, blistering, cracking, oozing, or bleeding. Areas of temporary skin discoloration may appear and are sometimes due to healed lesions, although scarring is rare. Photograph of typical, mild dermatitis File history Legend: (cur) = this is the current file, (del) = delete this old version, (rev) = revert to this old version. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // L00-L99 - Diseases of the skin and subcutaneous tissue (L00-L08) Infections of the skin and subcutaneous tissue (L00) Staphylococcal scalded skin syndrome (L01) Impetigo (L02) Cutaneous abscess, furuncle and carbuncle (L03) Cellulitis (L04) Acute lymphadenitis (L05) Pilonidal cyst (L08) Other local infections of skin and subcutaneous tissue (L081) Erythrasma... // L00-L99 - Diseases of the skin and subcutaneous tissue (L00-L08) Infections of the skin and subcutaneous tissue (L00) Staphylococcal scalded skin syndrome (L01) Impetigo (L02) Cutaneous abscess, furuncle and carbuncle (L03) Cellulitis (L04) Acute lymphadenitis (L05) Pilonidal cyst (L08) Other local infections of skin and subcutaneous tissue (L081) Erythrasma... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Dermatitis is a blanket term literally meaning inflammation of the skin. It is usually used to refer to eczema, which is also known as Dermatitis eczema. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... This article is about the organ. ... A rash is a change in skin which affects its color, appearance, or texture. ... A symptom is a manifestation of a disease, indicating the nature of the disease, which is noticed by the patient. ... This page is about the condition called edema. ... Skin lesions caused by Chickenpox A lesion is any abnormal tissue found on or in an organism, usually damaged by disease or trauma. ... This article does not cite any references or sources. ...

Types

The term eczema refers to a set of clinical characteristics. Classification of the underlying diseases has been haphazard and unsystematic, with many synonyms used to describe the same condition. A type of eczema may be described by location (e.g. hand eczema), by specific appearance (eczema craquele or discoid), or by possible cause (varicose eczema). Further adding to the confusion, many sources use the term eczema and the term for the most common type of eczema (atopic eczema) interchangeably. Synonyms (in ancient Greek, συν (syn) = plus and όνομα (onoma) = name) are different words with similar or identical meanings. ... In art, craquelure is the fine pattern of cracks formed on old paintings. ...

More severe eczema

The European Academy of Allergology and Clinical Immunology (EAACI) published a position paper in 2001 which simplifies the nomenclature of allergy-related diseases including atopic and allergic contact eczemas.^[1] Non-allergic eczemas are not affected by this proposal. Image File history File links Eczema-arms. ... Image File history File links Eczema-arms. ...

The classification below is ordered by incidence frequency.

Types of common eczemas

• Atopic eczema (aka infantile e., flexural e., atopic dermatitis) is believed to have a hereditary component, and often runs in families whose members also have hay fever and asthma. Itchy rash is particularly noticeable on face and scalp, neck, inside of elbows, behind knees, and buttocks. Experts are urging doctors to be more vigilant in weeding out cases that are, in actuality, irritant contact dermatitis. It is very common in developed countries, and rising. (L20)
• Contact dermatitis is of two types: allergic (resulting from a delayed reaction to some allergen, such as poison ivy or nickel), and irritant (resulting from direct reaction to a solvent, such as sodium lauryl sulfate, for example). Some substances act both as allergen and irritant (wet cement, for example). Other substances cause a problem after sunlight exposure, bringing on phototoxic dermatitis. About three quarters of cases of contact eczema are of the irritant type, which is the most common occupational skin disease. Contact eczema is curable provided the offending substance can be avoided, and its traces removed from one’s environment. (L23; L24; L56.1; L56.0)
• Xerotic eczema (aka asteatotic e., e. craquele or craquelatum, winter itch, pruritus hiemalis) is dry skin that becomes so serious it turns into eczema. It worsens in dry winter weather, and limbs and trunk are most often affected. The itchy, tender skin resembles a dry, cracked, river bed. This disorder is very common among the older population. Ichthyosis is a related disorder. (L85.3; L85.0)
• Seborrhoeic dermatitis (aka cradle cap in infants, dandruff) causes dry or greasy scaling of the scalp and eyebrows. Scaly pimples and red patches sometimes appear in various adjacent places. In newborns it causes a thick, yellow crusty scalp rash called cradle cap which seems related to lack of biotin, and is often curable. (L21; L21.0)

Atopic dermatitis, sometimes called eczema is a kind of dermatitis, atopic, psychosomatic skin disease. ... For the play, see Hay Fever. ... A rash is a change in skin which affects its color, appearance, or texture. ... Contact dermatitis is a term for a skin reaction resulting from exposure to allergens or irritants. ... An allergen is any substance (antigen), most often eaten or inhaled, that is recognized by the immune system and causes an allergic reaction. ... Binomial name Toxicodendron radicans (L.) Kuntze Poison-ivy (Toxicodendron radicans or Rhus toxicodendron), in the family Anacardiaceae, is a woody vine that is well-known for its ability to produce urushiol, a skin irritant which for most people will cause an agonizing, itching rash. ... For other uses, see Nickel (disambiguation). ... Sodium dodecyl sulfate (SDS or NaDS) (CH3(CH2)11OSO3Na) (FW 288. ... Xerotic eczema refers to the skin changes that occur when skin becomes abnormally dry, itchy, and cracked. ... Ichthyosis is a family of genetic dermatological conditions seen in humans and domestic animals. ... An infant with Cradle Cap Close up image of Cradle Cap Cradle Cap (Infantile seborrhoeic dermatitis, or crusta lactea, milk crust, honeycomb disease; croûte de lait, eczéma infantile, dermatite atopique infantile (French); ne shqip njihet si - rrjebull ose rrjebulla (Albanian); crosta lattea (Italian); and σμηγματόρροια του τριχωτού της κεφαλής των νεογνών (Greek)) is a patchy... For the album by Ivor Cutler, see Dandruff (album). ... Vitamin H redirects here. ...

Less common eczemas

• Dyshidrosis (aka dyshidrotic e., pompholyx, vesicular palmoplantar dermatitis, housewife’s eczema) only occurs on palms, soles, and sides of fingers and toes. Tiny opaque bumps called vesicles, thickening, and cracks are accompanied by itching which gets worse at night. A common type of hand eczema, it worsens in warm weather. (L30.1)
• Discoid eczema (aka nummular e., exudative e., microbial e.) is characterized by round spots of oozing or dry rash, with clear boundaries, often on lower legs. It is usually worse in winter. Cause is unknown, and the condition tends to come and go. (L30.0)
• Venous eczema (aka gravitational e., stasis dermatitis, varicose e.) occurs in people with impaired circulation, varicose veins and edema, and is particularly common in the ankle area of people over 50. There is redness, scaling, darkening of the skin and itching. The disorder predisposes to leg ulcers. (I83.1)
• Dermatitis herpetiformis (aka Duhring’s Disease) causes intensely itchy and typically symmetrical rash on arms, thighs, knees, and back. It is directly related to celiac disease and can often be put into remission with appropriate diet. (L13.0)
• Neurodermatitis (aka lichen simplex chronicus, localized scratch dermatitis) is an itchy area of thickened, pigmented eczema patch that results from habitual rubbing and scratching. Usually there is only one spot. Often curable through behavior modification and anti-inflammatory medication. Prurigo nodularis is a related disorder showing multiple lumps. (L28.0; L28.1)
• Autoeczematization (aka id reaction, autosensitization) is an eczematous reaction to an infection with parasites, fungi, bacteria or viruses. It is completely curable with the clearance of the original infection that caused it. The appearance varies depending on the cause. It always occurs some distance away from the original infection. (L30.2)
• There are also eczemas overlaid by viral infections (e. herpeticum, e. vaccinatum), and eczemas resulting from underlying disease (e.g. lymphoma). Eczemas originating from ingestion of medications, foods, and chemicals, have not yet been clearly systematized. Other rare eczematous disorders exist in addition to those listed here.

A patch of eczema that has been scratched

Late stage of dyshidrosis on the hands Also known as Dyshidrotic Eczema Dyshidrotic Dermatitis Pompholyx Dyshidrosis is a skin condition that is characterized by small blisters on the hands or feet. ... Nummular dermatitis is one of the many forms of dermatitis. ... Stasis dermatitis refers to the skin changes that occur in the leg as a result of stasis or blood pooling from insufficient venous return. ... Venous ulcers are wounds that are thought to occur due to improper functioning of valves in the veins usually of the legs. ... Dermatitis herpetiformis (DH) or Duhrings Disease, is a skin disorder often associated with celiac disease. ... Coeliac disease (also termed non-tropical sprue, celiac disease and gluten intolerance) is an autoimmune disease characterised by chronic inflammation of the proximal portion of the small intestine caused by exposure to certain dietary gluten proteins. ... This article needs to be cleaned up to conform to a higher standard of quality. ... Lichen simplex chronicus is a skin disorder characterized by chronic itching and scratching. ... Habits are automatic routines of behavior that are repeated regularly, without thinking. ... Prurigo nodularis (PN) is a skin disease characterised by pruritic (itchy) nodules which usually appear on the arms or legs. ... Autoeczematization is also called -id reaction. ... Eczema vaccinatum skin rash. ... This article is about lymphoma in humans. ... Wikipedia does not have an article with this exact name. ... Wikipedia does not have an article with this exact name. ...

Diagnosis

Eczema diagnosis is generally based on the appearance of inflamed, itchy skin in eczema sensitive areas such as face, chest and other skin crease areas. For evaluation of the eczema, a scoring system can be used (for example, SCORAD, a scoring system for atopic dermatitis). Skin folds are areas of skin where it folds. ... (SCORing Atopic Dermatitis) A clinical tool for assessing the severity (i. ...

Given the many possible reasons for eczema flare-ups, a doctor is likely to ascertain a number of other things before making a judgment:

• An insight to family history
• Dietary habits
• Lifestyle habits
• Allergic tendencies
• Any prescribed drug intake
• Any chemical or material exposure at home or workplace

To determine whether an eczema flare is the result of an allergen, a doctor may test the blood for the levels of antibodies and the numbers of certain types of cells. In eczema, the blood may show a raised IgE or an eosinophilia. IGE (Internet Gaming Entertainment) is the largest MMORPG services company world-wide, with offices in Los Angeles, Hong Kong, and Miami. ... Eosinophils are white blood cells that are responsible for combating infection by parasites in the body. ...

The blood can also be sent for a specific test called Radioallergosorbent Test (RAST) or a Paper Radioimmunosorbent Test (PRIST). In the test, blood is mixed separately with many different allergens and the antibody levels measured. High levels of antibodies in the blood signify an allergy to that substance. Allergic diseases are a rapidly growing health problem. A precise, reliable in vitro test for IgE antibodies to specific substances is a valuable tool to support the clinician in making diagnoses of or excluding allergy, prescribing and following up treatment, and predicting disease development. A RAST test (short for radioallergosorbent test) is a blood test used to determine what a person is allergic to. ... This article needs cleanup. ... In vitro (Latin: within the glass) refers to the technique of performing a given experiment in a test tube, or, generally, in a controlled environment outside a living organism. ... IGE (Internet Gaming Entertainment) is the largest MMORPG services company world-wide, with offices in Los Angeles, Hong Kong, and Miami. ... Wikipedia does not yet have an article with this exact name. ... Allergy is an abnormal reaction to a substance foreign to the body that is acquired, predictable and rapid. ...

In order to understand an evolving allergic disease it is necessary to gain more detailed information about the ongoing IgE sensitization process in the patient. Such accurate information can only be obtained through quantitative measurements of the levels of IgE antibodies to different allergens in the blood. One such quantitative test is the ImmunoCAP test giving the results in kU A /l rather than in classes, the requirements for accuracy are even higher. IGE (Internet Gaming Entertainment) is the largest MMORPG services company world-wide, with offices in Los Angeles, Hong Kong, and Miami. ...

Another test for eczema is skin patch testing. The suspected irritant is applied to the skin and held in place with an adhesive patch. Another patch with nothing is also applied as a control. After 24 to 48 hours, the patch is removed. If the skin under the suspect patch is red and swollen, the patch test result is considered positive and suggests that the person is probably allergic to the suspected irritant. A patch test is a method used to determine if a specific substance causes inflammation of the skin. ...

Occasionally, the diagnosis may also involve a skin biopsy which is a procedure that removes a small piece of the affected skin that is sent for microscopic examination in a pathology laboratory. Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... A microscope (Greek: (micron) = small + (skopein) = to look at) is an instrument for viewing objects that are too small to be seen by the naked or unaided eye. ... A renal cell carcinoma (chromophobe type) viewed on a hematoxylin & eosin stained slide Pathologist redirects here. ...

Blood tests and biopsies are not always necessary for eczema diagnosis. However, doctors will at times require them if the symptoms are unusual, severe or in order to identify particular triggers.

Treatment

This section needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (May 2008)

This article may require cleanup to meet Wikipedia's quality standards. Please improve this article if you can. (May 2008)

There is no known cure for eczema, thus treatments aim to control the symptoms: reduce inflammation and relieve itching.

Medications

Corticosteroids

Dermatitis is often treated by glucocorticoid (a corticosteroid steroid) ointments, creams or lotions. They do not cure eczema, but are highly effective in controlling or suppressing symptoms in most cases.^[2] Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger similar effects. ... In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ... This article is about the chemical family of steroids. ...

For mild-moderate eczema a weak steroid may be used (e.g. hydrocortisone or desonide), whilst more severe cases require a higher-potency steroid (e.g. clobetasol propionate, fluocinonide). Medium-potency corticosteroids such as clobetasone butyrate (Eumovate), Betamethasone Valerate (Betnovate) or triamcinolone are also available. Generally medical practitioners will prescribe the less potent ones first before trying the more potent ones. In many countries, weak steroids such as hydrocortisone can be purchased 'over the counter' (e.g., hydrocortisone in UK, US, Germany, Czechia), while the more potent ones require a prescription. Hydrocortisone is a synthetic corticosteroid drug which may be given by injection or by topical application. ... Desonide is an anti-inflammatory corticosteroid typically used topically. ... Clobetasol Propionate comes in ointment and emollient cream presentations. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... Clobetasone is a corticosteroid used in dermatology and ophthalmology. ... Betamethasone dipropionate is a corticosteroid with anti-inflammatory and immunosuppressive abilities, used especially where water retention is undesirable. ... Triamcinolone (trade names Kenalog, Aristocort, Nasacort, Tri-Nasal, Triderm, Azmacort, Trilone, Volon A, Tristoject, Fougera;) is a synthetic corticosteroid given orally, by injection, inhalation, or as a topical ointment or cream. ... The United Kingdom of Great Britain and Northern Ireland is a country in western Europe, and member of the Commonwealth of Nations, the G8, the European Union, and NATO. Usually known simply as the United Kingdom, the UK, or (inaccurately) as Great Britain or Britain, the UK has four constituent... United States may refer to: Places: United States of America SS United States, the fastest ocean liner ever built. ... Czechia is an official shorthand term for the Czech Republic. ...

Side effects

Prolonged use of topical corticosteroids is thought to increase the risk of possible side effects, the most common of which is the skin becoming thin and fragile (atrophy).^[3] Because of this, if used on the face or other delicate skin, only a low-strength steroid should be used. Additionally, high-strength steroids used over large areas, or under occlusion, may be significantly absorbed into the body, causing hypothalamic-pituitary-adrenal axis suppression (HPA Axis suppression).^[4] Finally by their immunosuppressive action they can, if used without antibiotics or antifungal drugs, lead to some skin infections (fungal or bacterial). Care must be taken to avoid the eyes, as topical corticosteroids applied to the eye can cause glaucoma ^[5] or cataracts. Atrophy is the partial or complete wasting away of a part of the body. ... An occlusive dressing is an air- and water-tight trauma dressing used in first aid. ... It has been suggested that HTPA be merged into this article or section. ... Staphylococcus aureus - Antibiotics test plate. ... An antifungal drug is medication used to treat fungal infections such as athletes foot, ringworm, candidiasis (thrush), serious systemic infections such as cryptococcal meningitis, and others. ... Divisions Chytridiomycota Zygomycota Ascomycota Basidiomycota The Fungi (singular: fungus) are a large group of organisms ranked as a kingdom within the Domain Eukaryota. ... Phyla Actinobacteria Aquificae Chlamydiae Bacteroidetes/Chlorobi Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Lentisphaerae Nitrospirae Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Verrucomicrobia Bacteria (singular: bacterium) are unicellular microorganisms. ...

Because of the risks associated with this type of drug, a steroid of an appropriate strength should be sparingly applied only to control an episode of eczema. Once the desired response has been achieved, it should be discontinued and replaced with emollients as maintenance therapy. Corticosteroids are generally considered safe to use in the short- to medium-term for controlling eczema, with no significant side effects differing from treatment with non-steroidal ointment.^[6]

However, recent research has shown that topically applied corticosteroids did not significantly increase the risk of skin thinning, stretch marks or HPA axis suppression (and where such suppression did occur, it was mild and reversible where the corticosteroids were used for limited periods of time). Further, skin conditions are often under-treated because of fears of side effects. This has lead some researchers to suggest that the usual dosage instructions should be changed from "Use sparingly" to "Apply enough to cover affected areas," and that specific dosage directions using "fingertip units" or FTU's be provided, along with photos to illustrate FTU's.^[7]

Other forms

In severe cases, oral cortisosteroids such as prednisolone or injections such as triamcinolone injections may also be prescribed. While these usually bring about rapid improvements, they should not be taken for any length of time and the eczema often returns to its previous level of severity once the medication is stopped. In the case of triamcinolone injections, a waiting period between treatments may be required. Prednisolone is the active metabolite of prednisone. ... Triamcinolone (trade names Kenalog, Aristocort, Nasacort, Tri-Nasal, Triderm, Azmacort, Trilone, Volon A, Tristoject, Fougera;) is a synthetic corticosteroid given orally, by injection, inhalation, or as a topical ointment or cream. ... Triamcinolone (trade names Kenalog, Aristocort, Nasacort, Tri-Nasal, Triderm, Azmacort, Trilone, Volon A, Tristoject, Fougera;) is a synthetic corticosteroid given orally, by injection, inhalation, or as a topical ointment or cream. ...

Immunomodulators

Topical immunomodulators like pimecrolimus (Elidel and Douglan) and tacrolimus (Protopic) were developed after corticosteroid treatments, effectively suppressing the immune system in the affected area, and appear to yield better results in some populations. The US Food and Drug Administration has issued a public health advisory about the possible risk of lymph node or skin cancer from use of these products,^[8] but many professional medical organizations disagree with the FDA's findings; An immunomodulator is a drug used for its effect on the immune system: drugs may be immunosuppressants or immunostimulators. ... Pimecrolimus is an immunomodulating agent used in the treatment of atopic dermatitis. ... Tacrolimus (also FK-506 or Fujimycin) is an immunosuppressive drug whose main use is after allogenic organ transplant to reduce the activity of the patients immune system and so the risk of organ rejection. ... In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ... FDA redirects here. ...

• The postulation is that the immune system may help remove some pre-cancerous abnormal cells which is prevented by these drugs. However, any chronic inflammatory condition such as eczema, by the very nature of increased metabolism and cell replication, has a tiny associated risk of cancer (see Bowen's disease).
• Current practice by UK dermatologists is not to consider this a significant real concern and they are increasingly recommending the use of these new drugs.^[9] The dramatic improvement on the condition can significantly improve the quality of life of sufferers (and families kept awake by the distress of affected children). The major debate, in the UK, has been about the cost of such newer treatments and, given only finite NHS resources, when they are most appropriate to use.^[10]
• In addition to cancer risk, there are other potential side effects with this class of drugs. Adverse reactions including severe flushing, photosensitive reactivity and possible drug interaction in patients who consume even small amounts of alcohol.^[11]

In medicine (dermatology), Bowens disease (BD) is a sunlight-induced skin disease, considered either as an early stage or intraepidermal form of squamous cell carcinoma. ... The National Health Service (NHS) is the publicly-funded healthcare system of the United Kingdom. ...

Antibiotics

When the normal protective barrier of the skin is disrupted (dry and cracked), it allows easy entry for bacteria. Scratching by the patient both introduces infection and spreads it from one area to another. Any skin infection further irritates the skin and a rapid deterioration in the condition may ensue; the appropriate antibiotic should be given. Phyla Actinobacteria Aquificae Chlamydiae Bacteroidetes/Chlorobi Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Lentisphaerae Nitrospirae Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Verrucomicrobia Bacteria (singular: bacterium) are unicellular microorganisms. ... Staphylococcus aureus - Antibiotics test plate. ...

Immunosuppressants

When eczema is severe and does not respond to other forms of treatment, immunosuppressant drugs are sometimes prescribed. These dampen the immune system and can result in dramatic improvements to the patient's eczema. However, immunosuppresants can cause side effects on the body. As such, patients must undergo regular blood tests and be closely monitored by a doctor. In the UK, the most commonly used immunosuppressants for eczema are ciclosporin, azathioprine and methotrexate. These drugs were generally designed for other medical conditions but have been found to be effective against eczema. Commonly prescribed as a immunosuppressant in the United States for Eczema is the steroid Predisolone. Immunosuppression is the medical suppression of the immune system. ... Ciclosporin (INN), cyclosporine or cyclosporin (former BAN), is an immunosuppressant drug. ... Azathioprine is a chemotherapy drug, now rarely used for chemotherapy but more for immunosuppression in organ transplantation, autoimmune disease such as rheumatoid arthritis or inflammatory bowel disease such as Crohns disease. ... Amethopterin redirects here. ...

Itch relief

Anti-itch drugs, often antihistamine, may reduce the itch during a flare up of eczema, and the reduced scratching in turn reduces damage and irritation to the skin (the Itch cycle). Antipruritics, also known as anti-itch drugs, are medications that inhibit the itching (Latin: pruritus) that is often associated with sunburns, allergic reactions, eczema, psoriasis, chickenpox, fungal infections, insect bites and stings like those from mosquitoes, fleas, and mites, and contact dermatitis and urticaria caused by plants such as poison... An H1 antihistamine is a histamine antagonist which serves to reduce or eliminate effects mediated by histamine, an endogenous chemical mediator released during allergic reactions, through action at the H1 receptor. ... An itch (Latin: pruritus) is an uncomfortable sensation felt on an area of skin that causes a person or animal to desire to scratch that area. ...

Capsaicin applied to the skin acts as a counter irritant (see Gate control theory of nerve signal transmission). Other agents that act on nerve transmissions, like menthol, also have been found to mitigate the body's itch signals, providing some relief. Recent research suggests Naloxone hydrochloride and dibucaine suppress the itch cycle in atopic-dermatitis model mice as well. Capsaicin (8-methyl-N-vanillyl-6-nonenamide) is the active component of chilli peppers, which are plants belonging to the genus Capsicum. ... The gate control theory of pain, put forward by Ronald Melzack and Patrick Wall in 1962 [1], and again in 1965 [2], is the idea that physical pain is not a direct result of activation of pain receptor neurons, but rather its perception is modulated by interaction between different neurons. ... Menthol is a covalent organic compound made synthetically or obtained from peppermint or other mint oils. ... Naloxone is a drug used to counter the effects of overdosing on opioids such as heroin and morphine. ... Cinchocaine (or Dibucaine) is an amide local anesthetic. ...

Avoiding dry skin

Moisturizing

Eczema can be exacerbated by dryness of the skin. Moisturizing is one of the most important self-care treatments for sufferers of eczema. Keeping the affected area moistened can promote skin healing and relief of symptoms.

Soaps and harsh detergents should not be used on affected skin because they can strip natural skin oils and lead to excessive dryness. Instead, the use of moisturizing body wash, or an emollient like aqueous cream, will maintain natural skin oils and may reduce some of the need to moisturize the skin. Another option is to try bathing using colloidal oatmeal bath treatments. In addition to avoiding soap, other products that may dry the skin such as powders or perfume should also be avoided. For other uses, see Soap (disambiguation). ... Aqueous Cream BP is a medicinal substance officially registered in the British Pharmacopoeia. ...

Moistening agents are called 'emollients'. In general, it is best to match thicker ointments to the driest, flakiest skin. Light emollients like aqueous cream may not have any effect on severely dry skin. Some common emollients for the relief of eczema include Oilatum, Balneum, Medi Oil, Diprobase, bath oils and aqueous cream. Sebexol, Epaderm ointment and Eucerin lotion or cream may also be helpful with itching. Lotions or creams may be applied directly to the skin after bathing to lock in moisture. Moisturizing gloves (gloves which keep emollients in contact with skin on the hands) can be worn while sleeping. Generally, twice-daily applications of emollients work best. While creams are easy to apply, they are quickly absorbed into the skin, and therefore need frequent reapplication. Ointments, with less water content, stay on the skin for longer and need fewer applications, but they can be greasy and inconvenient. Emollients are substances which soften and soothe the skin. ... Aqueous Cream BP is a medicinal substance officially registered in the British Pharmacopoeia. ... Emollients soften skin (and moisturisers add moisture). ... An ointment is a viscous semisolid preparation used topically on a variety of body surfaces. ...

For unbroken skin, direct application of waterproof tape with or without an emollient or prescription ointment can improve moisture levels and skin integrity which allows the skin to heal. This treatment regimen can also help prevent the skin from cracking, as well as put a stop to the itch cycle. The end result is reduced lichenification (the roughening of skin from repeated scratching). Taping works best on skin away from joints.

There is a disagreement whether baths are desirable or a necessary evil. For example Mayoclinic advises against daily baths to avoid skin drying.^[12]. On the other hand, U.S. National Eczema Association claims that "the best way to get water into your skin is to briefly soak in a bath or shower and to moisturize immediately afterwards."^[13]. Similarly, The Eczema Society of Canada recommends frequent baths.^[14]

Eczema and skin cleansers

The first and primary recommendation is that people suffering from eczema shouldn't use detergents of any kind on their skin unless absolutely necessary.^{[citation needed]} Eczema sufferers can reduce pruritus by using cleansers only when water is not sufficient to remove dirt from skin.

However, detergents are so ubiquitous in modern environments in items like tissues, and so persistent on surfaces, "safe" soaps are necessary to remove them from the skin in order to control eczema. Although most eczema recommendations use the terms "detergents" and "soaps" interchangeably, and tell eczema sufferers to avoid both, detergents and soaps are not the same and are not equally problematic to eczema sufferers. Detergents, often made from petrochemicals, increase the permeability of skin membranes in a way that soaps and water alone do not. Sodium lauryl sulfate, the most common household detergent, has been shown to amplify the allergenicity of other substances ("increase antigen penetration").^[15] Laundry detergents are just one of many possible uses for detergents Detergent is a compound, or a mixture of compounds, intended to assist cleaning. ... For other uses, see Soap (disambiguation). ...

Unfortunately there is no one agreed-upon best kind of skin cleanser for eczema sufferers. Different clinical tests, sponsored by different personal product companies, unsurprisingly tout various brands as the most skin-friendly based on specific properties of various products and different underlying assumptions as to what really determines skin friendliness. The terms "hypoallergenic" and "doctor tested" are not regulated,^[16] and no research has been done showing that products labeled "hypoallergenic" are in fact less problematic than any others.

Dermatological recommendations in choosing a soap generally include:^{[citation needed]}

• Avoid harsh detergents or drying soaps
• Choose a soap that has an oil or fat base; a "superfatted" goat milk soap is best
• Use an unscented soap
• Patch test your soap choice, by using it only on a small area until you are sure of its results
• Use a non-soap based cleanser
• Use plain yogurt instead of soap

Instructions for using soap:

• Use soap sparingly
• Avoid using washcloths, sponges, or loofahs, or anything that will abrade the skin
• Use soap only on areas where it is necessary
• Soap up only at the very end of your bath
• Use a fragrance-free barrier-type moisturizer such as petroleum jelly before drying off
• Use care when selecting lotion, soap, or perfumes to avoid suspected allergens; ask your doctor for recommendations
• Never rub your skin dry, or else your skin's oil/moisture will be on the towel and not your body; pat dry instead

Moisturizers are a complex mixture of chemical agents specially designed to make the external layers of the skin (epidermis) softer and more pliable, by increasing its hydration (water content). ... White Petrolatum Petroleum jelly, vaseline, petrolatum or soft paraffin [2] is a semi-solid mixture of hydrocarbons (with carbon numbers mainly higher than 25),[3] originally promoted as a topical ointment for its healing properties. ...

Pseudoceramides

On August 27, 2007, scientists led by Jeung-Hoon Lee created in the laboratory synthetic lipids called pseudoceramides which are involved in skin cell growth and could be used in treating skin diseases such as atopic dermatitis, a form of eczema characterized by red, flaky and very itchy skin; psoriasis, a disease that causes red scaly patches on the skin; and glucocorticoid-induced epidermal atrophy, in which the skin shrinks due to skin cell loss.^[17] For a List of scientists, see: List of anthropologists List of astronomers List of biologists List of chemists List of computer scientists List of economists List of engineers List of geologists List of inventors List of mathematicians List of meteorologists List of physicists Scientist pairs List of scientist pairs See... This article does not cite any references or sources. ... Skin cells have most common organelles in them. ... Dermatology is a branch of medicine dealing with the skin, its structure, functions, and diseases (from Greek derma, skin), as well as its appendages (nails, hair, sweat glands). ...

Environmental measures

While it has been suggested that eczema may sometimes be an allergic reaction to the excrement from house dust mites,^[18] with up to 5% of people showing antibodies to the mites,^[19] the overall role this plays awaits further corroboration.^[20] Feces (also spelled faeces or fæces) are the waste products from the digestive tract expelled through the anus during defecation. ... Binomial name Trouessart, 1897 The house dust mite (sometimes abbreviated by allergists to HDM), is a cosmopolitan guest in human habitation. ...

Various measures may reduce the amount of mite antigens, in particular swapping carpets for hard surfaces.^[21] Effectiveness of vacuum cleaners is dependent upon the characteristics of the carpet pile,^[22] but in other studies daily vacuuming did not affect levels of mites.^[23] However it is not clear whether such measures actually help patients with eczema. A controlled study suggested that a number of environmental factors such as air exchange rates, relative humidity and room temperature (but not the level of house dust mites) might have an effect on the condition.^[24] Regular canister vacuum cleaner for home use. ...

Light therapy

Light therapy using ultraviolet light can help control eczema.^[25] UVA is mostly used, but UVB and Narrow Band UVB are also used. Ultraviolet light exposure carries its own risks, particularly eventual skin cancer from exposure.^[26] Light therapy or phototherapy consists of exposure to specific ranges of light wavelengths (using lasers or LEDs), or very bright, full-spectrum light, for a prescribed amount of time. ... For other uses, see Ultraviolet (disambiguation). ... Uva is a three-letter abbreviation with multiple meanings, as described below: Uva Province in Sri Lanka Uva is a parish in the Portuguese municipality of Vimioso Ultraviolet-A rays (UV-A) Ultraviolet Light Absorber University of Virginia (UVa), in the United States Universiteit van Amsterdam (UvA), one of the... Note: Ultraviolet is also the name of a 1998 UK television miniseries about vampires. ...

When light therapy alone is found to be ineffective, the treatment is performed with the application (or ingestion) of a substance called psoralen. This PUVA (Psoralen + UVA) combination therapy is termed photo-chemotherapy. Psoralens make the skin more sensitive to UV light, thus allowing lower doses of UVA to be used. However, the increased sensitivity to UV light also puts the patient at greater risk for skin cancer.^[27] Psoralen (also called psoralene) is the parent compound in a family of natural products known as furocoumarins. ... PUVA is a Psoralen + UVA treatment. ...

It has been suggested that eczema can be cured by UV Rays, i.e. sunbathing or using tanning beds. Some people have been able to abate their symptoms through this treatment, but this should be supervised by a dermatologist.

Diet and nutrition

Recent studies provide hints that food allergy may trigger atopic dermatitis. For these people, identifying the allergens could lead to an avoidance diet to help minimize symptoms, although this approach is still in an experimental stage. ^[28] A food allergy is an immunologic response to a food protein. ...

Dietary elements that have been reported to trigger eczema include dairy products and coffee (both caffeinated and decaffeinated), soybean products, eggs, nuts, wheat and maize (sweet corn), though food allergies may vary from person to person.^{[citation needed]} For other uses, see Coffee (disambiguation). ... Soy redirects here. ... Chicken egg (left) and quail eggs (right), the types of egg commonly used as food An egg is a body consisting of an ovum surrounded by layers of membranes and an outer casing of some type, which acts to nourish and protect a developing embryo. ... Look up nuts in Wiktionary, the free dictionary. ... Species T. aestivum T. boeoticum T. dicoccoides T. dicoccon T. durum T. monococcum T. spelta T. sphaerococcum T. timopheevii References:   ITIS 42236 2002-09-22 Wheat Wheat For the indie rock group, see Wheat (band). ... This article is about the maize plant. ...

Recently German scientists discovered that a diet rich in Omega-3 may be able to reduce symptoms. ^[29]

Alternative therapies

Non-conventional medical approaches include traditional Chinese medicine and Western herbalism - suggest a wide variety of treatments, each of which may vary from individual to individual as to efficacy or harm. Some of these remedies are for topical use. Patients should inform their doctor/allergist/dermatologist if they are pursuing one of these treatment routes. Traditional Chinese medicine shop in Tsim Sha Tsui, Hong Kong. ... Herbalism is a traditional medicinal or folk medicine practice based on the use of plants and plant extracts. ...

• Oatmeal is a common remedy to relieve itching, and can be applied topically as a cream or, as a colloid, in the bath. It is also part of many commercially available products intended for eczema treatment.
• Sulfur has been used for many years as a topical treatment in the alleviation of eczema, although this could be suppressive. It was fashionable in the Victorian and Edwardian eras. Recently sulfur has regained some popularity as a homeopathic alternative to steroids and coal tar. However, there is currently no scientific evidence for the claim that sulfur treatment relieves eczema.^[30]
• Aloe Vera
• Potentilla chinensis
• Aebia clematidis
• Clematis armandii
• Rehmannia glutinosa
• Paeonia lactiflora (Chinese Peony)
• Lophatherum gracile
• Dictamnus dasycarpus
• Tribulus terrestris
• Glycyrrhiza uralensis
• Glycyrrhiza glabra (Licorice)
• Schizonepeta tenuifolia (Neem)
• Schizonepeta tennuifolia
• Azadirachta indica
• Evening primrose oil
• Tea tree oil
• Burdock
• Rooibos
• Linseed oil
• Calamine
• Cod liver oil
• Neem oil
• Aloe propolis cream^{[citation needed]}
• Raw goat's milk^{[citation needed]}
• Grapefruit seed extract (GSE)^{[citation needed]}
• Hemp cream^{[citation needed]}
• Gotu Kola^{[citation needed]}
• Emu Oil
• Crocodile Oil

Many patients find that swimming in the ocean will relieve symptoms and clear up the red patchy scales. In the United States and Canada, oatmeal means any crushed oats, rolled oats, or cut oats used in recipes such as oatmeal cookies. ... A Colloid or colloidal dispersion is a type of homogeneous mixture. ... This article is about the chemical element. ... Binomial name (L.) Burm. ... Binomial name Paeonia lactiflora Pall. ... Binomial name Linnaeus Tribulus terrestris is a flowering plant in the family Zygophyllaceae, native to warm temperate and tropical regions of the Old World in southern Europe, southern Asia, throughout Africa, and in northern Australia. ... Species Glycyrrhiza acanthocarpa Glycyrrhiza aspera Glycyrrhiza astragalina Glycyrrhiza bucharica Glycyrrhiza echinata Glycyrrhiza eglandulosa Glycyrrhiza foetida Glycyrrhiza foetidissima Glycyrrhiza glabra Glycyrrhiza gontscharovii Glycyrrhiza iconica Glycyrrhiza korshinskyi Glycyrrhiza lepidota Glycyrrhiza pallidiflora Glycyrrhiza squamulosa Glycyrrhiza triphylla Glycyrrhiza uralensis Glycyrrhiza yunnanensis Glycyrrhiza is a genus of about 18 accepted species in the family Fabaceae... Species Glycyrrhiza acanthocarpa Glycyrrhiza aspera Glycyrrhiza astragalina Glycyrrhiza bucharica Glycyrrhiza echinata Glycyrrhiza eurycarpa Glycyrrhiza foetida Glycyrrhiza glabra Glycyrrhiza iconica Glycyrrhiza korshinskyi Glycyrrhiza lepidota Glycyrrhiza pallidiflora Glycyrrhiza triphylla Glycyrrhiza uralensis Glycyrrhiza yunnanensis Ref: ILDIS Version 6. ... Binomial name Azadirachta indica A. Juss. ... Species Oenothera biennis Oenothera fruticosa Oenothera speciosa et al Oenothera is a genus of about 125 species of annual, biennial and perennial herbs. ... Tea Tree Oil (Melaleuca Oil) Tea tree oil or melaleuca oil is a clear to very pale golden color essential oil with a fresh camphoraceous odour. ... This article does not cite any references or sources. ... Binomial name (N.L.Burm. ... Flax oil (in bottles) and coconut oil (in jars in the middle) Linseed oil, also known as flax seed oil, is a yellowish drying oil derived from the dried ripe seeds of the flax plant (Linum usitatissimum, Linaceae). ... Calamine is a mixture of zinc oxide (ZnO) with about 0. ... Capsules of Cod Liver Oil Cod liver oil, as its name suggests, is an oil extracted from cod livers. ... This article does not cite any references or sources. ... Grapefruit seed extract (GSE), also known as citrus seed extract, is a liquid derived from the seeds, pulp, and white membranes of grapefruit. ... Binomial name Bacopa monnieri L. Pennell Water Hyssop (Bacopa monnieri) is a perennial, creeping herb, also known as brahmi (note. ... For other uses, see EMU. Binomial name (Latham, 1790) The Emu has been recorded in the areas shown in orange. ... Crocodile oil has been used for centuries to heal many skin ailments including psoriasis and eczema. ...

Patients can also wear clothing designed specifically to manage the itching, scratching and peeling associated with eczema.

Behavioural approach

In the 1980s, Swedish dermatologist Dr Peter Noren developed a behavioural approach to the treatment of long term atopic eczema. This approach has been further developed by dermatologist Dr Richard Staughton and psychiatrist Christopher Bridgett at the Chelsea and Westminster Hospital in London.^[31][32] Dermatology is a branch of medicine dealing with the skin, its structure, functions, and diseases (from Greek derma, skin), as well as its appendages (nails, hair, sweat glands). ... For other uses, see Psychiatrist (disambiguation). ... Chelsea and Westminster Hospital is a public hospital located on Fulham Road, in the South Kensington area of London. ...

Patients undergo a 6 week monitored program involving scratch habit reversal and self awareness of scratching levels. For long term eczema sufferers, scratching can become habitual. Sometimes scratching becomes a reflex, resulting in scratching without conscious awareness, rather than from the feeling of itchiness itself. The habit reversal programme is done in conjunction with the standard applied emollient/corticosteroid treatments so that the skin can heal. It also reduces future scratching, as well as reduces the likelihood of further flareups. The behavioural approach can give an eczema sufferer some control over the degree of severity of eczema.

Research

Other than direct treatments of the symptoms, no cure is presently known for most types of dermatitis; even cortisone treatments and immunomodulation may often have only minor effects on what may be a complex problem. As the condition is often related to family history of allergies (and thus heredity), it is probable that gene therapy or genetic engineering might help. Gene therapy is the insertion of genes into an individuals cells and tissues to treat a disease, and hereditary diseases in which a defective mutant allele is replaced with a functional one. ... Elements of genetic engineering Genetic engineering, recombinant DNA technology, genetic modification/manipulation (GM) and gene splicing are terms that are applied to the direct manipulation of an organisms genes. ...

Damage from the enzymatic activity of allergens is usually prevented by the body's own protease inhibitors, such as, LEKTI, produced from the gene SPINK5. Mutations in this gene are known to cause Netherton’s syndrome, which is a congenital erythroderma. These patients nearly always develop atopic disease, including hay fever, food allergy, urticaria and asthma. Such evidence supports the hypothesis that skin damage from allergens may be the cause of eczema, and may provide a venue for further treatment. ^[33] Ribbon diagram of the enzyme TIM, surrounded by the space-filling model of the protein. ... Protease inhibitor can refer to: Protease inhibitor (pharmacology): a class of medication that inhibits viral protease Protease inhibitor (biology): a group of proteins that inhibit proteases. ... A congenital disorder is a medical condition or defect that is present at or before birth (for example, congenital heart disease). ... Erythroderma refers to a skin disorder characterized by the widespread reddening of the skin. ...

Another study identified a gene that the researchers believe to be the cause of inherited eczema and some related disorders. The gene produces the protein filaggrin, the lack of which causes dry skin and impaired skin barrier function.^[34] Filaggrins are filament-associated proteins which bind to keratin fibers in epidermal cells. ...

A recent study indicated that two specific chemicals found in the blood are connected to the itching sensations associated with eczema. The chemicals are Brain-derived neurotrophic factor (BDNF) and Substance P.^[35] Brain-derived neurotrophic factor (BDNF) is exactly as it states; a neurotrophic factor usually derived in the brain. ... In neuroscience, Substance P is a neuropeptide: a short-chain polypeptide that functions as a neurotransmitter and as a neuromodulator. ...

Vulnerability to live vaccinia virus

In June, 2007, Science magazine reported that an American soldier who had been vaccinated for smallpox, a vaccine that contains live vaccinia virus, had transmitted vaccinia virus to his two-year-old son.^[36] The soldier and his son both had a history of eczema. The son rapidly came down with a rare side effect, eczema vaccinatum, which had been seen during the 1960s when children were routinely vaccinated against smallpox. The child developed a severe full-body pustular rash, his abdomen filled with fluid, and his kidneys nearly failed. Intense consultation with experts from the Centers for Disease Control and Prevention and a donation of an experimental antiviral drug by SIGA Technologies saved the child's life. Those with a family history of eczema are advised not to accept the smallpox vaccination, or anything else that contains live vaccinia virus. The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, is recognized as the leading United States agency for protecting the public health and safety of people. ...

References

A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... The United States Food and Drug Administration is the government agency responsible for regulating food, dietary supplements, drugs, cosmetics, medical devices, biologics and blood products in the United States. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 289th day of the year (290th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 289th day of the year (290th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance with the Gregorian calendar. ... is the 127th day of the year (128th in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance with the Gregorian calendar. ... is the 127th day of the year (128th in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance with the Gregorian calendar. ... is the 127th day of the year (128th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 279th day of the year (280th in leap years) in the Gregorian calendar. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 290th day of the year (291st in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance with the Gregorian calendar. ... is the 113th day of the year (114th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 288th day of the year (289th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 289th day of the year (290th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

External links

Look up Eczema in
Wiktionary, the free dictionary.

• MedlinePlus: Dermatitis
• National Eczema Society (UK)
• Mayo Clinic: Dermatitis and Eczema - Overview, Treatment, Causes, Prevention, Self-Care
• National Eczema Association (US)