Eczema
Eczema, or sometimes called atopic dermatitis, is a chronic, inflamed rash on the skin. It presents as dry skin that can sometimes have intense itching. The exact cause is not known by scientists at this time. However, there is a genetic component, as well as environmental exposures, that contribute to it. Those with eczema often have allergies.
Signs or Symptoms
Eczema has multiple presentations and can change as one ages. In the rash form, it presents as scaly, eroded, thickened skin that can be darker or lighter than the surrounding skin. When on the hands, eczema looks like painful vesicles that can weep or even bleed.
Intense itching is almost always present. Thickening of the skin, called lichenification, can occur when eczema has been present for years. The breakdown in your normal skin barrier that occurs in this disease leads to increased skin infections, particularly with Staphylococcus aureus, the herpes virus, or Coxsackievirus.
Those with allergies, asthma and other skin diseases are more likely to develop it. Eczema typically starts as a child and then progresses and persists into adulthood. Adults with this condition have persistent dry skin, dermatitis or dark circles around the eyes, and painful bumps and blisters on their hands.
Treatment Options
The first step to treating eczema is reviewing one's skincare regimen. High quality moisturizers and gentle cleansers are the critical first step. In the dry winter months, a thick moisturizer, such as petroleum jelly, can be used to help those severely affected. Fragrance free soaps and detergents are beneficial for many who have allergies.
When conservative measures don’t work, prescription topical steroids and new or non-steroid agents, such as Tacrolimus or Eucrisa (crisaborole) can be used. Oral antihistamines help decrease the itching in any infection needing to be cleared with topical or oral antibiotics. For severe cases, oral medications or a new biologic medication called Dupixent (dupilumab) are highly effective.
Patch Testing
Those who continue to be affected by allergies can be treated with a painless procedure known as patch testing to identify allergies. Unlike the shots in prick testing used for systemic allergies, patch testing in dermatology involves the application of various agents on the back to test for an allergic response. A patch is applied to the back and left for two days and the allergy is then identified. It is a simple and painless procedure that can be performed for people of almost any age.