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Eczema or dermatitis is a term to describe a group of common chronic inflammatory skin disorders, that present with ill defined itchy scaly pink patches. Where there is constant rubbing, the skin becomes thickened and the skin lines becomes more prominent. This is called lichenification. Chronic eczema of the hands and feet can also causes fissures which can be painful and are difficult to heal. In some cases where eczema condition is more acute, blisters and weeping can be seen. Secondary bacteria infection (impetiginized eczema) can cause yellow crusting and this may require treatment with topical or oral antibiotics if severe.
There are many types of eczema:
Atopic dermatitis is very common. Often starts in infancy after the age of 3 months, although 30% may outgrow the disease, it can persists into adulthood. 20% of North American children are affected.
Common areas of involvement in older kids and adults are face, neck, skin folds especially at the elbows and knees.
Often seen in patients with atopic eczema/dermatitis. This infection of Herpes Virus type I can be very severe. It may appear as many blisters and sores over the face or body. Patients often feels unwell with a fever in severe cases. This is an emergency and should be seen as quickly as possible.
Hand eczema is very common, it could be due to Atopic dermatitis, Irritant contact dermatitis, Allergic contact dermatitis, Pomphylx eczema and a combination of these.
Vesicles are predominantly seen in this type of eczema. It may be associated with sweating, seasonal changes, presence of atopy (atopic eczema, asthma and seasonal allergy). Allergy to Nickel and fungal infection of feet can also presents with similar blistering of palms and soles.
Most common seen in young adults and middle age adults. This is often seen on face, scalp and chest areas as redness and greasy scales. Itching may or may not be present. There is often a positive family history and is made worse by stress and sun exposure. Treatment is often with anti-dandruff or salicylic or tar shampoos, anti-yeast topical treatment and topical steroids often in combination.
Irritant Contact Eczema
Detergents, cleaning agents, fragrances are all irritating to the skin. Over time with repeated contact, you may develop irritant contact eczema. It usually presents itching, redness, scaling and fissuring of skin. Face and hands are common areas. Contact with strong acids and alkalis can cause an acute irritant reaction like blister formation.
Allergic Contact Eczema