10 eczema facts

10 eczema facts

In this article we will describe 10 facts about eczema.

Key Points

• Eczema is a chronic inflammatory skin condition characterized by dry, itchy, and scaly skin.
• Prevalence in the UK is approximately 15-20% in children and 5-10% in adults.
• Atopic eczema is the most common type, often associated with asthma and allergies.
• Diagnosis is primarily clinical, with investigations reserved for uncertain cases or severe disease.
• Treatment focuses on topical corticosteroids, moisturizers, and lifestyle modifications.

1. Definition

• Eczema, also known as atopic dermatitis, is a chronic or recurrent inflammatory skin condition marked by dryness, itching, and scaling.
• The term ‘eczema’ encompasses various clinical entities, including atopic, contact, seborrhoeic, and nummular eczema.

• Atopic Eczema: Most common type, often associated with asthma, allergies, and family history.
• Contact Dermatitis: Caused by skin contact with irritants or allergens.
• Seborrhoeic Eczema: Typically affects oily areas, such as scalp, face, and chest.
• Nummular Eczema: Coin-shaped patches, often on legs.
• Dyshidrotic Eczema: Vesicular lesions on palms and soles.

• Prevalence in UK children: 15-20%.
• Prevalence in UK adults: 5-10%.
• Higher incidence in urban areas and developed countries.
• Increased prevalence in families with atopic diseases.

• Family history of eczema, asthma, or allergies.
• Urban residence.
• Developed country.
• Hygiene hypothesis (reduced exposure to childhood infections).
• Genetic predisposition.

• Genetic factors.
• Environmental triggers (allergens, irritants, stress).
• Imbalanced immune response.
• Skin barrier dysfunction.

• Dry, scaly, or cracked skin – especially on flexor surfaces (front of elbow, back of knee).
• Intense itching (pruritus).
• Redness and inflammation.
• Skin thickening (lichenification).
• Papules, vesicles, or pustules.

Typical flexural (i.e. in the creases) eczema

• History.
• Physical examination.
• Symptom severity.

• Uncertain diagnosis.
• Severe disease.
• Suspected allergies or infections.

• Skin prick testing.
• Patch testing.
• Blood tests (IgE, eosinophils).
• Skin scraping or biopsy.

• Psoriasis.
• Dermatitis herpetiformis.
• Ichthyosis.
• Allergic contact dermatitis.
• Scabies.

• Topical Corticosteroids: First-line treatment for inflammation.
• Moisturisers: Emollients and humectants for dry skin.
• Topical Immunomodulators: For severe or recalcitrant cases.
• Antibiotics: For secondary infections.
• Lifestyle Modifications:
  • Avoid soaps and harsh cleansers.
  • Wear breathable clothing.
  • Maintain skin hydration.
  • Control anxiety.

• Initial diagnosis.
• Severe or worsening symptoms.
• Poor response to treatment.
• Suspected complications (e.g. skin infections).
• Consider referral to dermatology for severe or complex cases.

• Secondary skin infections (bacterial, viral, or fungal).
• Eczema herpeticum (widespread viral infection)
• Lichenification and skin thickening.
• Mental health impacts (anxiety, depression).

• Variable disease course.
• Remissions and exacerbations common.
• Early intervention and adherence to treatment improve outcomes.

• Breastfeeding and maternal avoidance of allergenic foods.
• Early introduction of solids.
• Avoidance of soaps and harsh cleansers.
• Regular moisturising.
• Stress management.

Summary

We have described 10 facts about eczema. We hope it has been helpful.