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Eczema

Definition

Eczema is a chronic skin disorder that involves scaly and itchy rashes. Eczema is also called atopic dermatitis.

Alternative Names

Infantile eczema; Atopic dermatitis; Dermatitis - atopic

Causes, incidence, and risk factors

Eczema is due to a hypersensitivity reaction (similar to an allergy) in the skin, which leads to long-term inflammation. The inflammation causes the skin to become itchy and scaly. Long-term irritation and scratching can cause the skin to thicken and an have a leather-like texture.

Eczema is most common in infants, and at least half of those cases clear by age 3. In adults, it is generally a long-term or recurring condition. Eczema tends to run in families.

People with eczema often have a family history of allergic conditions like asthma, hay fever, or eczema.

The following can make eczema symptoms worse:

  • Dry skin
  • Exposure to environmental irritants
  • Exposure to water
  • Stress
  • Temperature changes

Symptoms

  • Blisters with oozing and crusting
  • Dry, leathery skin areas
  • Ear discharge or bleeding
  • Intense itching
  • Rash
    • In children younger than age 2, skin lesions begin on the cheeks, elbows, or knees
    • In adults, the rash is more commonly seen on the inside of the knees and elbows
  • Raw areas of the skin from scratching
  • Skin coloring changes -- more or less coloring than the normal skin tone (See: Skin bnormally dark or light)
  • Skin redness or inflammation around the blisters

Signs and tests

Diagnosis is primarily based on the appearance of the skin and on personal and family history. The health care provider should examine the lesions to rule out other possible causes. A skin lesion biopsy may be performed, but is not always required to make the diagnosis.

Treatment

Treatment may vary depending on the appearance (stage) of the lesions -- acute "weeping" lesions, dry scaly lesions, or chronic dry, thickened lesions are each treated differently.

Avoid anything that makes the symptoms worse. This may include food allergens and irritants such as wool and lanolin.

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