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Atopic dermatitis – Wikipedia, the free encyclopedia

Atopic dermatitis (AD), also known as atopic eczema, is a type of inflammation of the skin (dermatitis). It results in itchy, red, swollen, and cracked skin. Clear fluid may come from the affected areas which often become thickened over time.[1] It typically starts in childhood with changing severity over the years.[1][2] In children under one year of age much of the body may be affected. As they get older the back of the knees and front of the elbows are the most common area for the rash. In adults the hands and feet are most affected.[2] Scratching worsens symptoms and affected people have an increased risk of skin infections. Many people with atopic dermatitis develop hay fever or asthma.[1]

The cause is not known but believed to involve genetics, immune system dysfunction, environmental exposures, and difficulties with the permeability of the skin.[1][2] If one identical twin is affected there is an 85% chance the other will also have the condition.[3] Those who live in cities and dry climates are more commonly affected. Exposure to chemicals or frequent hand washing makes symptoms worse. While emotional stress may make the symptoms worse it is not a cause. The disorder is not contagious.[1] The diagnosis is typically based on the signs and symptoms. Other diseases that need to be excluded before making a diagnosis include contact dermatitis, psoriasis, and seborrheic dermatitis.[2]

Treatment involves avoiding things that make it worse, daily bathing with application of a moisturising cream afterwards, applying steroid creams when flares occur, and medications to help with itchiness.[2] Things that commonly make it worse include wool clothing, soaps, perfumes, chlorine, dust, and cigarette smoke. Phototherapy may be useful in some people. Steroid pills may occasionally be used if other measures are not effective.[1] Antibiotics (either by mouth or topically) may be needed if a bacterial infection develop.[2] Dietary changes are only needed if food allergies are suspected.[1]

Atopic dermatitis affects about 20% of people at some point in their lives.[1][4] It is more common in younger children.[2] Males and females are equally affected.[1] Many people outgrow the condition.[2] Atopic dermatitis is sometimes called eczema, a term that also refers to a larger group of skin conditions.[1] Other names include "infantile eczema", "flexural eczema", "prurigo Besnier", "allergic eczema", and "neurodermatitis".[5]

People with AD often have dry and scaly skin that spans the entire body, except perhaps the diaper area, and intensely itchy red, splotchy, raised lesions to form in the bends of the arms or legs, face, and neck.[6][7][8][9][10] These lesions then weep, crack, swell, and crust over.[10] These lesions are at a heightened risk for bacterial, fungal, or viral colonisation.[10]

The cause of AD is not known, although there is some evidence of genetic factors, and some evidence that growing up in a sanitary environment encourages AD.[7]

It seems to have a genetic component. Many people with AD have a family history of atopy. Atopy is an immediate-onset allergic reaction such as asthma, food allergies, AD or hay fever.[6][7] In 2006 it was discovered that mutations in the gene for the production of filaggrin strongly increased the risk for developing atopic dermatitis. Most importantly two mutations were found that affect approximately 5% of people in Western Europe that may disrupt the production of filaggrin. Filaggrin is a protein that plays an important role in the retention of water in the stratum corneum. People who have these mutations often have dry skin.[11] Filaggrin also plays an important role in keeping the skin surface slightly acidic, hence giving it anti-microbial effects. It is broken down into trans-urocanic acid which keeps the pH low.[12]

According to the hygiene hypothesis, when children are brought up exposed to allergens in the environment at a young age, their immune system is more likely to tolerate them, while children brought up in a modern "sanitary" environment are less likely to be exposed to those allergens at a young age, and, when they are finally exposed, develop allergies. There is some support for this hypothesis with respect to AD.

Those exposed to dogs while growing up have a lower risk of atopic dermatitis.[13] There is also support from epidemiological studies for a protective role for helminths against AD.[14] Likewise children with poor hygiene are at a lower risk for developing AD, as are children who drink unpasteurised milk.[14] Exposure to dust mites is believed to contribute to one's risk of developing AD.[15]

A diet high in fruits seems to have a protective effect against AD, whereas the opposite seems to be true for fast foods.[14]

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Eczema: Read About Treatment of Various Eczema Types

Eczema facts What is eczema?

Rather than a specific condition, eczema is a group of unrelated diseases that have a similar appearance. When it is new eczema, the affected skin appears red and elevated with small blisters (vesicles) containing a clear fluid. When the blisters break, the affected skin will weep and ooze. In older eczema, chronic eczema, the blisters are less prominent and the skin is thickened, elevated, and scaling. Eczema almost always is very itchy.

There are at least 11 different types of skin conditions that produce eczema. In order to develop a rational treatment plan, it is important to distinguish them. This is often not easy.

Medically Reviewed by a Doctor on 1/26/2015

Eczema - Treatment Question: What treatment has been effective for your eczema?

Eczema - Symptoms and Signs Question: What were your eczema symptoms and signs?

Eczema - Experience Question: Please describe your experience with eczema.

Eczema - Home Remedies Question: What home remedies have been effective for your eczema?

Eczema - Types Question: What type of eczema did you have, and what causes eczema?

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Eczema: Read About Symptoms, Treatment and Causes

Eczema (Atopic Dermatitis) Eczema Overview

The term eczema is derived from the Greek, meaning "to boil out." The name is particularly apt since to ancient medical practitioners it may have appeared that the skin was "boiling." Today the usage is rather imprecise since this term is frequently used to describe any sort of dermatitis (inflammatory skin condition). But not all dermatitis is eczematous. All eczematous dermatitis, whether due to a familial atopic dermatitis or an acquired allergic contact dermatitis, has a similar appearance. Acute lesions are composed of many small fluid-filled structures called vesicles that usually reside on red, swollen skin. When these vesicles break, clear or yellowish fluid leaks out, causing characteristic weeping and oozing. When the fluid dries, it produces a thin crust which may mimic impetigo. In older lesions, these vesicles may be harder to appreciate, but an examination of the tissue under the microscope will reveal their presence. Eczematous dermatitis has many causes. One of the most common is a condition called atopic dermatitis. Often those using the term eczema are referring to atopic dermatitis. Although atopy refers to a lifelong inherited (genetic) predisposition to inhalant allergies such as asthma and allergic rhinitis (hay fever), atopic dermatitis is not known at this time to be a pure allergic disease. Atopic patients are likely to have asthma, hay fever, and dermatitis. Atopy is a very common condition, and it affects all races and ages, including infants. About 1%-2% of adults have the skin rash, and it is even more common in children. Most affected individuals have their first episode before 5 years of age. For most, the dermatitis will improve with time. For an unlucky few, atopic dermatitis is a chronic, recurrent disorder.

Other eczematous dermatoses include, but are not limited to, allergic contact dermatitis (cell-mediated allergy to a common substance such as poison oak or nickel), irritant dermatitis (from excessive contact with a harsh chemical substance), fungal infections, scabies infestations, stasis dermatitis, very dry skin (asteatosis), pompholyx (dyshidrosis), nummular dermatitis, and seborrheic dermatitis. The differentiation among these conditions is often difficult and time consuming. In addition, it is not uncommon for atopic dermatitis to coexist with another eczematous dermatitis.

Medically Reviewed by a Doctor on 5/12/2015

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Eczema: Definition, Causes, Treatments & Pictures

What Is Eczema?

Eczema is a common skin condition marked itchy and inflamed patches of skin. It is also known as atopic dermatitis. It is more common in babies and young children. It occurs on the faces of infants, as well as inside the elbows and behind the knees of children, teenagers, and adults. It is caused by an overactive immune system. Up to 20 percent of children and one to three percent of adults develop atopic dermatitis, according to the American Academy of Dermatology. In rare cases, atopic dermatitis can first appear during puberty or adulthood. It affects males and females equally.

When people refer to eczema, they usually mean atopic dermatitis, which is the common and chronic type of eczema. Other types include:

Find out if you're eligible to participate in an atopic dermatitis clinical trial

An eczema flare-up is when one or more eczema symptoms appear on the skin. The cause of eczema is not fully understood.

It is thought to be triggered by an overactive immune system that responds aggressively to the presence of irritants.

Eczema is sometimes caused in part by an abnormal response to proteins that are part of the body. Normally, the immune system ignores proteins that are part of the human body and attacks only the proteins of invaders, such as bacteria or viruses. In eczema, the immune system loses the ability to distinguish between the two, which causes inflammation.

Common triggers of eczema flare-ups include:

Other triggers include stress, food allergies, animal dander, and upper respiratory infections.

Eczema is characterized by itchy, dry, rough, flakey, inflamed, and irritated skin. It can flare up, subside, and then flare up again. It can occur anywhere but usually affects the arm, inner elbow, back of the knee, or head (particularly the cheeks and the scalp). It is not contagious and becomes less severe with age.

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Eczema | University of Maryland Medical Center

Introduction

Eczema is a chronic, inflammatory skin disorder. It can appear as blisters that crust over to become scaly, itchy rashes, or as dry, thick patches of skin with scales. The main symptom is itching, and symptoms can come and go. Although eczema is not contagious, it is very common. People with eczema often have a personal or family history of allergies. There is no cure, however, treatments can reduce symptoms and help prevent outbreaks.

The most common signs of eczema are:

Eczema in children under 2 years old generally starts on the cheeks, elbows, or knees. In adults, it tends to be found on the inside surfaces of the knees and elbows.

Researchers do notknow for sure what causes eczema. It may be a combination of hereditary (genetic) and environmental factors. In some people, allergies may trigger eczema. Exposure to certain irritants and allergens can make symptoms worse, as can dry skin, exposure to water, temperature changes, and stress.

Stress can make eczema worse. Other irritants that can make eczema worse include:

Wool or synthetic fibers

Certain soaps and detergents, as well as perfumes and some cosmetics

Dust or sand

Cigarette smoke

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Dyshidrotic Eczema Pictures, Causes, Home Remedies …

What is Dyshidrotic Eczema?

This is a skin problem which is also known as dyshidrosis, or pompholyx. This skin condition creates fluid-filled, small blisters or vesicles on the soles of the feet or palms of the hands or both.

These blisters occurring in dyshidrotic eczema normally last around 3 weeks and causes extreme itching. When these blisters dry, cracks and groves or fissures develop, which are very painful.

Management for dyshidrotic eczema most often requires topical creams, ultraviolet light or wet compresses to improve the appearance as well as ease symptoms.

The cause of dyshidrotic eczema is not known. But, it can be linked with a similar disorder of the skin known as atopic dermatitis as well as allergic conditions, for instance asthma and hay fever known as allergic rhinitis. Eruptions can be seasonal in individuals with allergies.

With dyshidrotic eczema, the affected areas of the skin come to be inflamed. Because of this, the connections between the cells of the skin open and this allows fluid or serum to seal these spaces. Physicians denote this development as spongiosis since when viewed under microscope; the skin appears sponge-like with these numerous fluid-filled spaces.

Signs or symptoms of dyshidrotic eczema include:

Risk aspects for dyshidrotic eczema include:

Females seem to have this condition more than men

Appear to be more frequent during stressful times

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