Prem Menon, M.D. Vimla Menon, M.D.
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Asthma, Allergy and Immunology Center
Home | Allergy Information | Eczema (Atopic Dermatitis)
Eczema (Atopic Dermatitis)
Atopic eczema (Atopic Dermatitis) is the most common chronic skin disorder, often caused or compounded by allergies to foods. An increase in the worldwide prevalence of atopic eczema has been observed.
While atopic dermatitis can occur at any age, it is the most common childhood skin disease, with a lifetime prevalence of 10 to 20% in children.
In this condition, the skin is dry, itchy and inflamed. First comes an intense feeling of itching - then rash appears, followed by more itch. Hence the patient has vicious cycles of itch - scratch - rash - more itch. A common description of eczema is the ‘itch that rashes’. The persistent sensation of intense itching causes loss of sleep for the patients and caretakers, staphylococcal superinfection of the skin lesions, thickening of the skin and hyperpigmentation and diminished quality of life for the patient and family.
At different ages, the physical appearance of Eczema can vary:
- Infancy – 2 years old: Red, weeping, crusted lesions on the face, scalp, arms, and legs
- Age 2-12: Eczema appears in the skin-fold areas, especially in the crease of the elbow, behind the knee, inside the wrist, and on the ankles and neck
- Puberty: Eczema might clear up or flare-up occasionally
*Eczema is NOT contagious*
Certain triggers can make an eczema rash worse such as:
- Dry skin
- Irritants (detergents, fragrances, wool fabrics, paints)
- Allergens (food, pollen, pet dander, dust mites)
- Heat and sweating
- Infection
Treatment of Eczema
- Generous doses of one or more antihistamines.
- Hydration of the skin by frequent and prolonged baths.
- Profuse use of moisturizers.
- Wet-to–dry dressings after coating the skin with a heavy-duty moisturizer.
- Wet Pajamas: After a bath, apply a generous amount of moisturizer. Then dress the child in the damp pajamas. Apply another pair of dry cotton pajamas on top of the wet pajamas.
- Cover the child’s hands and feet with cotton socks.
- Topical anti-inflammatory ointments, as needed.
- Oral anti-inflammatory or immunosuppressant medications, in selected patients.
- Allergy desensitization injections with inhalant aeroallergens.
- A breakthrough drug Dupilumab, IL 4 Receptor blocker, monoclonal antibody, is undergoing clinical trials and is expected to be FDA approved in 2017.
Atopic eczema is often the first manifestation of the atopic patient’s "ALLERGY MARCH" i.e. march from Eczema - to Hay Fever - to Asthma.
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