10 eczema facts

10 eczema facts

In this article we will describe 10 facts about eczema.

5 Key Points

1. Eczema is a chronic inflammatory skin condition characterised by dry, itchy, and scaly skin.
2. Prevalence in the UK is approximately 15-20% in children and 5-10% in adults – i.e very common
3. Atopic eczema is the most common type, often associated with asthma and allergies.
4. Diagnosis is primarily clinical, with investigations reserved for uncertain cases or severe disease.
5. Treatment focuses on topical corticosteroids, moisturisers, 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.