(a.k.a. atopic eczema), often used synonymously with eczema, is a disease of unknown cause. It usually starts in infancy (before the first birthday) and is characterized by itchy, scaly lesions, xerosis (dry skin), and lichenification (accentuation of skin markings).
Atopic dermatitis is commonly associated with other atopic diseases such as asthma or allergic rhinitis. The frequency of atopic dermatitis appears to be increasing and appears to be more common among Blacks and Asians than before. In infants, eczema is usually seen on the forehead and cheeks. In children, eczema is seen on the hands, wrists, ankles, feet, and elbow and knee creases. In adults, eczema is usually seen on the face, neck, upper arms and back, elbow and knee creases, and back of the hands, feet, fingers, and toes.
Although it remains unclear as to what the cause of the condition is, dermatologists believe environmental factors such as mold, pollen, and pollutants play a role in triggering an episode of Atopic Dermatitis. Soaps, detergents, and perfumes are also believed to trigger the condition.
(a.k.a. nummular eczema) appears as itchy “coin-shaped” areas of inflammation and can be crusty or scaly.
Nummular Dermatitis is a common form of dermatitis that develops after the skin experiences trauma (skin injury such as a burn, abrasion, or insect bite). That being the case, the most common areas that develop nummular dermatitis are arms, knees, legs, and buttocks. The hallmark of this condition are unique coin-shaped (nummular) or oval lesions and patches of irritated and itchy skin.
Xerotic (asteatotic) Eczema:
(a.k.a asteatotic eczema), in this type of eczema, extremely dry skin becomes inflamed and may require treatment beyond moisturizers.
in this form of eczema, skin irritation can form from excessive contact with irritants (e.g., soap, detergents, harsh chemicals) and allergens (e.g., poison ivy, nickel, fragrances, etc.). Contact dermatitis brings along redness, itching, and burning in areas where the skin has come into contact with the allergen.
Due to the vast number of substances with which individuals come in contact with on a daily basis, it can be difficult to determine the exact trigger for contact dermatitis. When the contact leads to irritated skin, the eczema is called irritant contact dermatitis. As with atopic dermatitis mentioned above, it is very common to find that those with contact dermatitis have a family history of the condition.
This form of eczema occurs on the palms of the hands, sides of the fingers, and soles of the feet. Dyshidrotic dermatitis typically causes a burning or itching sensation along with a blistering rash. In our office, one may hear a doctor refer to this condition by a different synonym such as hand eczema, pompholyx, vesicular eczema, and vesicular palmoplantar eczema.
As mentioned above, there are several different and unique types of eczema. Hand eczema or hand dermatitis does not refer to one specific type of eczema, but rather is a broad and general name given to conditions of eczema that develop on the hands. The reason hand eczema is given specific attention by medical professionals is that hand eczema is often the result of one’s occupation. The cause of allergy may be directly related to their specific occupation.
Neurodermatitis, as its name implies, stems from a condition in the body’s nervous system. This form of dermatitis arises when nerve endings in the skin become irritated, triggering a severe itch-scratch-itch cycle.
Patients with this condition report that endless scratching does little to relieve the itching sensation of the condition. Common causes of nerve irritation include an insect bite and emotional stress. Women are more likely to develop Neurodermatitis than men. The condition generally will present itself between the ages of 25 and 50 and can result in thickened and leathery skin.
Seborrheic dermatitis generally presents on the scalp as oily and waxy patches. It is not uncommon for this form of dermatitis to spread to the face, cheeks, and shoulders. Seborrheic dermatitis does not necessarily have the “itching sensation” that come along with other forms of eczema. As mentioned previously, seborrheic dermatitis has a tendency to flare up when exposed to triggers such as cold temperatures and dry weather.
Stasis dermatitis occurs almost exclusively in middle-aged people. As one ages, circulation in the lower extremities such as the legs begins to slow. Diminished blood flow to the lower extremities can lead to a fluid build-up. This ultimately leads to swelling that affects the skin by causing an itchy rash with painful sores and skin discoloration. To effectively treat this form of dermatitis, our doctors will not only take into account the trauma to the skin, but will focus on correcting the circulation problem thereby diminishing the swelling which will ultimately terminate the skin condition.
Eczema can also look different in darker skinned patients. Some of the unique forms of eczema seen more commonly in darker skin include papular eczema (bumps) and eczema with follicular prominence.
A major concern for people with dark skin is the skin discoloration associated with eczema. Eczema or scratching secondary to the itch of eczema can lead to darkening (hyperpigmentation) or lightening (hypopigmentation) of the skin. This discoloration can last for months to years, even after the eczema is treated. Darkening of the skin is especially visible in children with skin of color. If the patient’s underlying eczema and inflammation is treated, however, the changes in skin color can be improved.
There are many helpful, easy ways to treat or soothe eczema. The first step is to avoid irritants or allergens, to which your body may react. Vigilant moisturization is the mainstay of treatment of atopic dermatitis and is also quite helpful in other forms of eczema. Gentle skin care is also recommended:
A dermatologist may also prescribe a topical corticosteroid. These steroids help with both acute and chronic eczema and help to reduce inflammation.
Eczema, especially atopic dermatitis, is often secondarily infected, so your dermatologist may also prescribe antibiotics or anti-bacterial cleansers to treat any associated infections. Rarely, in severe cases, eczema is treated with systemic medications that alter the immune system.
Instead of scratching and irritating the skin, one should use a cold compress to control the uncomfortable sensation and should visit a dermatologist to start an appropriate treatment plan.
To learn more about Eczema, contact us today to schedule an appointment with our dermatologists.