tag:blogger.com,1999:blog-63109264838267249352011-11-27T16:32:33.007-08:00we offer support for people with eczema and their carers, with an information and eczema advice servicedr.ahmed.ezzhttp://www.blogger.com/profile/08496232982855422741noreply@blogger.comBlogger521100tag:blogger.com,1999:blog-6310926483826724935.post-8810382490558756722009-04-01T07:37:00.000-07:002009-04-01T07:38:14.449-07:00

IntroductionThe treatment of eczema should reflect the needs of the individualand their eczema. The extent of the eczema and the areas affectedwill influence the choice of treatment. Although there are a varietyof different treatment approaches, first-line therapy usually involvesa topical skin-care regime in which creams or ointments are applieddirectly to the skin. This usually involves the

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Apart from following the advice in the chapter on treatment, thereare some general measures that can be of benefit. As with otherbits of general advice in this book, the measures may apply muchmore to people with an atopic type of eczema:• Avoid any pets with furry or hairy coats, such as rabbits,hamsters, cats, dogs and horses. We don’t advise getting ridof existing pets, but you might want to

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Unless there is a very strong link with her eczema, i.e. every timethese foods are consumed the eczema becomes worse, we do notthink that this is necessary. Colourings and additives may beimportant with some children with another disorder called urticariaor hives, but the link with eczema is very tenuous. In practice, theyare extremely difficult to avoid as they seem to be added to so manyfoods

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Yes, we would occasionally consider a dairy-free diet in a child lessthan 1 year old if other conventional treatments were not workingwell. In addition, if there were a clear-cut history of a certain foodmaking the eczema worse every time it was consumed, we wouldconsider a 3-month exclusion trial.To ensure that adequate nutrition is provided, a dietitian shouldsupervise any dietary approach. A

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A number of research studies have examined the role of diet inatopic eczema so this answer really only applies if you have thistype. These studies have looked at exclusion of diary products,chicken, wheat, flavourings and additives. Some studies seem toindicate a link, but many of the newer studies do not show anyrelationship. You have to remember that all studies of eczema aredifficult, for three

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My symptoms of eczema seems to be much worse now assoon as I get home from work. As soon as I get in, I startscratching for no reason, and it gets worse over theevening and in my sleep. Why is this happening?The pattern of scratching and irritation you describe could arisefor a number of reasons. First, consider your home environment:for example, do you keep your home very warm? The use of

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My daughter had to be admitted urgently to hospitalbecause her eczema was bad and she became very floppyand ill. I thought eczema was ‘just a skin disease’.It sounds as though your daughter’s eczema has been very severe.As you say, many people see eczema simply as ‘just a skin disease’,but the skin is the body’s largest organ, and it is responsible formaintaining temperature control and fluid

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It sounds as though you have had a change in the pigment in yourskin. Episodes of inflammation in the skin from eczema and othercauses can lead to pigment changes, leaving the skin lighter ordarker. We call this process post-inflammatory hypo- (if lighter) orhyper- (if darker) pigmentation. The darker your skin is to startwith, the more likely it is to get darker still. Except in a few cases,the

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Molluscum, also called molluscum contagiosum, is a type of tinywart in the skin that looks rather like small, translucent blisters.These are caused by an infection with a poxvirus. Some peoplerefer to them as water warts, although they are in fact solid. Theyare dome shaped and often have a small depression or punctumon the top. Molluscum is common in children and young adults,and is more

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Viral warts are very common in all children, especially on the handsand feet. They are often noticed more readily in children witheczema because such children are already being seen by doctorsabout their eczema and are having their skin examined morefrequently. Warts are not necessarily more common in children –or adults – with eczema, but there is some evidence that theybecome more numerous once

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I was diagnosed with eczema herpeticum, which clearedup quickly after treatment with aciclovir. Is there moreinformation on this condition?Eczema herpeticum is a term used for a severe, widespread skininfection with the herpes virus that occasionally occurs in peoplewith eczema. Herpes infections are usually localised, causing a fewblisters or a cold sore on the lip. Eczema herpeticum shows

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Bacterial infectionMy son’s eczema became much worse and wasn’timproving with the creams. The GP said it was infectedand gave him a course of antibiotics. What caused thisinfection, and can it be dangerous?We all have micro-organisms on our skin called Staphylococcusaureus. In eczematous skin, the barrier function is not workingeffectively, and micro-organisms that come into contact with theskin

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IntroductionEczema is a condition that has a tendency to flare up and settle. Itwill often seem manageable and tolerable, but there may well betimes when the skin becomes more red and inflamed, with weepingareas and general background dryness. The chapters on treatmentwill help to give guidance on managing such flares, so this chapterwill concentrate on some factors that may tend to make eczemaworse

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I work in a sawmill and get eczema on my hands. This isput down to wear and tear, but recently I got eczema onmy face, which I think is also worse at work. Could it besomething in the air?You could have a combination of a physical contact irritant eczemafrom the wear and tear, and an allergic form from natural resins inthe wood or agents used to treat the wood. If the ventilation is poorand the

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Is it worth having tests for food intolerance? I haverecently read about this testing and about claims thatmost people get better after testing, although nothing hasbeen published. Is it worth doing?These tests are being developed but, at the time of writing, havenot been fully evaluated or validated. This process is very importantif the tests are to be used to change treatments or dietary

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My eczema doesn’t seem to behave as it should! I keepgetting flares around my eyes and eyelids, and my GPcan’t explain why. I always use the same creams, whichsometimes work and sometimes don’t. Should I see aconsultant?This is a common presentation of any allergic contact eczema.Unusual patterns like this should always suggest the need for allergytesting. The skin around the eyes and on the

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There is a great problem with the sort of testing you have had done.Often, there is very little science behind the test and the results,and we feel that the people doing the tests have a financial interestin the test being positive. Immunologists work much more withproperly researched and what we call ‘evidence-based’ tests so cangive more accurate results. If you tried to avoid the ‘whole list of

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I have heard a lot about different allergy tests and amconfused. My local supermarket offers tests of this kind,and a friend has also suggested an ELISA test. Can yougive me any more information about these types of testand allergy tests in general?‘Allergy tests’ mean different things to different people, and youwill hear a lot of conflicting information about their use. Broadlyspeaking, there

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During a recent bout of sickness and diarrhoea, mydaughter’s eczema almost disappeared. She ate hardlyanything during this time. Could this mean that hereczema is related to the food she eats?Unfortunately, this is not the likeliest explanation for theimprovement in your daughter’s eczema. Diet has not been shownto be a major factor in causing eczema, despite many people’s viewto the contrary.

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What are house dust mites?House dust mites are very small insects that are invisible to thenaked eye. They are found in all of our homes, and they particularlylike living in soft furnishings such as sofas, mattresses, carpets andduvets, where they are found in large numbers. Modern standardsof living, with central heating, seem to encourage their growth, andin practice they are difficult to

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Dogs, and indeed any animals with furry or hairy coats (e.g. horses,cats), shed their hair and skin into the environment. These smallparticles are made up of proteins that are ‘foreign’ to humans. Theycan irritate the skin without an allergic reaction taking place,especially if the skin is already damaged with eczema. They mayalso cause a genuine allergic response. Although breeds of dogswith

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In the late 1980s, it was noticed that large families seemed to havemuch less in the way of atopic disease. This was mainly found whenstudying asthma, for which the link is much more established thanit is for atopic eczema. (The link does not apply to other types ofeczema.) It is thought that allergic diseases might be more likely to developif the immune system of an infant or young child is

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It depends what you mean by ‘allergy’. The strictly scientificdefinition of allergy refers to ‘when a substance causes anabnormally excessive response to arise from the body’s immuneor defence system’. This may be measured by determining the levelsof antibody in the white blood cells (lymphocytes). The allergicreaction should be reproducible by ‘re-challenging’ with the samesubstance – the same

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I want to find out exactly what is causing my son’seczema. How can I get him tested?You have asked one of the most difficult questions to answerbecause we do not have a complete understanding of the cause orcauses of the various types of eczema. Your son is likely to haveatopic eczema as this is the most common childhood form, so it isunlikely to be due to a single allergy, for which avoidance of

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IntroductionIt must be very frustrating to ask your doctor why you have eczemaonly to get a vague answer suggesting several possible causes. Thetruth is that we don’t yet have a simple answer to this simplequestion – and we may never have. In this chapter we will try toexplain what our current understanding is and, just as importantly,try to dispel some of the myths that abound. It may be easier

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It is very difficult to tell you what this is without more information.At his age, it could be a condition called rosacea, which can causea red, sometimes bumpy, rash over the cheeks that can beassociated with irritation of the eyelids – called blepharitis. Rosaceacan also cause flushing and a burning feeling in the face afteralcohol, spicy foods or a sudden change of temperature. He shouldsee his

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High blood pressure (hypertension) seems to be rare in adults withatopic eczema, whether it is active or not. This has been found instudies, but no definite reason has yet been established.When I saw a dermatologist about my eczema, he said Ialso had keratosis pilaris and gave me a cream for that – Ithought it was all part of my eczema, but have I got twodiseases?Keratosis pilaris is a common

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For several years, I have been getting recurrent crops ofdry yellow blisters that come up on my hands on the palmside. They seem to start deep in the skin and end up onthe surface as a brown scale. Is this a form of eczema?This sounds as though it is a condition called palmar pustulosis,which can also affect the soles of the feet, when it is called palmo-plantar pustulosis. The yellow blisters

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Do people with eczema have a higher chance of developingasthma?Atopic eczema, asthma and hay fever tend to go together as ‘atopic’diseases. Asthma is a common disease in its own right as it affectsup to 10% of people at some time in their life. A child with eczemahas an increased risk of suffering from asthma as well – perhapsup to a 50% chance. Eczema tends to start earlier in life, andresearch

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Do boys get eczema more than girls?Yes, atopic eczema is a little more common in boys than girls.When does eczema start?It depends what sort of eczema you are talking about. The mostcommon form, atopic eczema, starts in childhood, and the earlierit starts, the more likely the child is to grow out of it. For example,if it starts before the age of 1, there is a more than 90% chance ofgrowing out of

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It is very difficult to answer this precisely as there are so manydifferent types of eczema. Skin disease in general can make uparound 15% of the workload of a GP, and a third of this is down toeczema. We know most about children with atopic eczema, anddifferent studies suggest that as many as 15% of those living indeveloped countries will suffer from eczema at some time. Thispercentage has been

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Surprisingly, this is a very difficult question to answer as the currentscientific understanding of itch is really very poor. We do knowthat certain small nerve fibres in the skin transmit ‘itch’ signals tothe spinal cord and then to the brain. These same fibres can alsotransmit pain signals. There are certain centres in the brain thatreceive these signals and then interpret them either as an

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I am afraid that we cannot explain why there are different patternsof eczema in different racial groups, but you are right to havespotted the difference. Eczema often affects the flexures (thecreases in front of the elbows and behind the knees), but in Asianand particularly in African/Caribbean people, eczema sometimesshows a reverse pattern, affecting the extensor surfaces (behindthe elbows and

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As there are no specific tests for most types of eczema, your doctorwill have reached a diagnosis on what we call ‘clinical grounds’.This means taking a careful history of the problem and any familyhistory of eczema, asthma or hay fever. Examination of the skinwill add to the clues in the history, allowing a diagnosis to be made.Some people with atopic eczema may have abnormal blood tests,such as

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As fluid accumulates in the epidermis, the ‘bricks’ separate and the‘cement’ becomes disrupted, leaving big cracks in the ‘barrier’.Irritants that would normally be kept on the surface are allowedthrough to the more sensitive dermis. Some irritants, such as soaps,act to dissolve the lipid-based cement, leading to a furtherbreakdown of the skin’s barrier function.

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If you think of the epidermis changing to look like a sponge, youcan imagine the fluid leaking out and making the outer layer stretchup into blisters. Once these break, you will be left with a wetweeping area as the skin has lost its barrier function.

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No, it is much more than that, and this accounts for the manyphysical and psychological effects that it can have, especially ifyou are badly affected by eczema. It is the last line of defenceagainst the outside world, protecting our bodies from externalattack and keeping the right conditions inside (homeostasis)through its prevention of loss of fluid and regulation of temperature.It also allows

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To explain what happens in eczema, you need to understand thestructure of the skin as seen down a microscope. The skin consistsof three layers:• The outer layer is called the epidermis. This contains a‘brick wall’ of skin cells (keratinocytes) that are heldtogether by a cement (the mortar) mostly made up of fatsor lipids. The many different layers start with live cells thatconstantly reproduce,

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Acute eczema will occur quite quickly – hours or a few days –sometimes in previously normal skin. Little blisters may appearand then break to give a weeping surface. The underlying skin willbe red, perhaps swollen and often a little bumpy. Most acute eczemais very itchy, but when the skin surface has broken down, this maybe replaced by soreness. As days go by, crusting and then scalingmay occur

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The age of onset can be helpful in deciding what type(s) of eczemaa person has. Eczema in an infant is most commonly atopic(although this may appear discoid in places and can be aggravatedby irritants) or seborrhoeic. In the child and teenager, atopic eczemais most common, but there will be some instances of contact allergy,for example to nickel. In adults of working age, irritant,

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Yes, it sounds as though you have venous eczema, also calledvaricose, stasis or gravitational eczema. It is linked to poor bloodflow in the veins in the lower legs, sometimes after clots in the deepveins. The eczema is chronic, and the legs can become stained abrowny colour from blood pigments getting into the skin. You willhave to be very careful not to scratch the skin as it will be veryfragile

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My gran has very itchy legs with not much to see otherthan dry skin with a sort of criss-cross pattern. She usedto get eczema as a child but says it didn’t look like this.She probably has asteatotic eczema, which occurs in older peoplewho may have had eczema in the past or have, at least, a tendencyto have dry skin. It is made worse by low humidity in centrallyheated rooms and the removal of the

dr.ahmed.ezzhttp://www.blogger.com/profile/08496232982855422741noreply@blogger.com0tag:blogger.com,1999:blog-6310926483826724935.post-48508774417992241592009-04-01T07:20:00.001-07:002009-04-01T07:20:28.537-07:00

If the watch strap is metal, you could be allergic to nickel and haveallergic contact eczema. This is different from irritant contacteczema in several ways as it is a type of immune problem called adelayed hypersensitivity reaction. The key points about it are:• previous contact is necessary to induce the response;• the response is specific to one substance;• all areas of skin will react once

dr.ahmed.ezzhttp://www.blogger.com/profile/08496232982855422741noreply@blogger.com0tag:blogger.com,1999:blog-6310926483826724935.post-68474300376840387652009-04-01T07:19:00.002-07:002009-04-01T07:20:04.591-07:00

This could be another form of irritant eczema. If it looks red anddry with cracks or fissures, it is probably ‘lip-licking’ eczema. Itmight also be linked to irritation from, or even allergy to, toothpaste.

dr.ahmed.ezzhttp://www.blogger.com/profile/08496232982855422741noreply@blogger.com0tag:blogger.com,1999:blog-6310926483826724935.post-36096420962273170602009-04-01T07:19:00.001-07:002009-04-01T07:19:44.374-07:00

As far as the basic underlying process in the skin goes, it is thesame as other types of eczema. It can be caused by a variety ofdifferent types of eczema, so the common thing is the site – on thehands. A background of atopic eczema, wet work and contactseems to be the most important factor, and it affects women morethan men. Environmental triggers from wet work and contact seemto be more

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There are actually three types of eczema that can affect the nappyarea. The most common is irritant eczema (nappy rash), which canaffect nearly all babies to some extent. This simply reflects the factthat urine and faeces are irritant to the skin if left in contact withit for prolonged periods. This type of nappy rash usually spares theskin right in the groins. The skin fold between the leg and

dr.ahmed.ezzhttp://www.blogger.com/profile/08496232982855422741noreply@blogger.com0tag:blogger.com,1999:blog-6310926483826724935.post-88791400489513050632009-04-01T07:17:00.002-07:002009-04-01T07:18:19.737-07:00

Unfortunately, most adults who have atopic eczema that haspersisted from childhood tend to find that it continues into old age.It is therefore very important that you work hard on finding atreatment regime that allows you to maThe health visitor says that my baby has cradle cap andthat this is a type of eczema. Is this true?Yes, this is a type of eczema called seborrhoeic eczema. It mayaffect

dr.ahmed.ezzhttp://www.blogger.com/profile/08496232982855422741noreply@blogger.com0tag:blogger.com,1999:blog-6310926483826724935.post-33158097611896822322009-04-01T07:17:00.001-07:002009-04-01T07:17:47.388-07:00

This comes from the word ‘atopy’, which refers to a group ofconditions in which the immune system reacts to allergens in theenvironment by producing raised levels of immunoglobulin typeE (IgE), which in turn leads to the changes in the skin. Seventy-five per cent of cases present before the age of 6 months, rising to90% before the age of 5 years. It is thought to affect 3% of infantsand persists

dr.ahmed.ezzhttp://www.blogger.com/profile/08496232982855422741noreply@blogger.com0tag:blogger.com,1999:blog-6310926483826724935.post-74050762752126559702009-04-01T07:16:00.000-07:002009-04-01T07:17:29.123-07:00

Yes, and no!‘Dermatitis’ is a more generalised word, simply meaninginflammation of the skin. All eczema is dermatitis, but many otherconditions that can be called dermatitis fall within the grouping ofdermatitis. Most of the different types of eczema can, and oftenare, interchangeably termed dermatitis – the term is morecommonly used in the USA. Previously more than now, aneczematous process

dr.ahmed.ezzhttp://www.blogger.com/profile/08496232982855422741noreply@blogger.com0tag:blogger.com,1999:blog-6310926483826724935.post-89420201378598992862009-04-01T07:15:00.001-07:002009-04-01T07:15:48.437-07:00

Unfortunately, no.There are many different causes and triggers for eczema – somefrom the outside world, for example irritants, allergy and bacterialinfection, and others from within the body. The ones from withinare called ‘intrinsic’ and include ‘atopy’ – having a genetic tendencyto eczema, asthma and hay fever – raised pressure in the leg veins,and reactions to stressful circumstances. These

dr.ahmed.ezzhttp://www.blogger.com/profile/08496232982855422741noreply@blogger.com0tag:blogger.com,1999:blog-6310926483826724935.post-65993624467887430682009-04-01T07:14:00.000-07:002009-04-01T07:15:22.226-07:00

IntroductionThe term ‘eczema’ is used for a group of conditions that show asimilar pattern of changes in the skin, giving rise to specific changeson the surface. The word itself comes from the Greek and means‘to boil or flow out’ – anyone who has had acute eczema willunderstand how appropriate this is.In acute (short-term) eczema, intense inflammation leads to theformation of little blisters (

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Definition – eczema is an inflammation of the skin frequently seen inassociation with the allergic conditions, asthma and hay fever. It ischaracterised by moist red weeping skin during the acute stages and dry,scaly skin in its more chronic forms.Distribution – most commonly affects the face and the knees and elbowsPrevalence – approximately 12–15 per cent of infants are affected by theso-called

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