Eczema

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Eczema

  1. 1. Eczema
  2. 2. Introduction • ‘Dermatitis' and ‘Eczema' are synonymous . • Statistics show 15-25% of all dermatological patients suffer from eczema. • Definition : – Eczema is a polymorphic inflammatory skin reaction involving the epidermis and upper dermis /papillary/.
  3. 3. • Clinical features may include itching, redness, scaling and clustered papulo- vesicles , excoriation , erosions etc…
  4. 4. Eczema clinical features
  5. 5. Classification • Acute : Red inflammed skin ,oozing , weeping , vesicles ,papules • Subacute : The presence of visible scale and crust associated with red inflamed skin • Chronic : Thickened, lichenified, often purple or violacious , elevated plaque
  6. 6. Other classification • Exogeneous : – trigerred by external factors • Endogenous : – the eczematous condition is not due to exogenous or external environmental factors, but is mediated by processes originating within the body
  7. 7. Atopic eczema LSC / lichen simplex chronicus Nummular eczema Pompholyx Asteatotic eczema Varicose eczema Seborrehic eczema Allergic contact eczema Irritant contact eczema Photo-contact dermatitis Endogeneous E Exogenous E
  8. 8. LSC / Neurodermatitis • Is the end effect of itch-scratch cycle • Lichenified skin has low threshold for itch • Seen in atopics or other itchy skin conditions
  9. 9. NUMMULAR ECZEMA • Also called discoid eczema • Cause is unknown • But unrelated to atopic diathesis • Incidence peaks in winter, when xerosis is maximal
  10. 10. Dyshidrotic eczema • Also known as Pompholyx • Affects the margins of the fingers and feet . • Lesions are erruptive vesicles and or bullae • About half the patients have an atopic background. • Emotional stress is possibly a precipitating factor • There is no evidence that sweating plays a role in the pathogenesis
  11. 11. Asteatoic eczema • Also ‘xerotic eczema • Winter itch • Eczema crackle • Dehydrated skin showing redness, scaling,and fine crackling resembling cracked porcelain or fissures in the bed of dired lake • Nummular lesions could occur , but Xerotic nummular lesoins are less weepy than classic nummullar eczema
  12. 12. Infective eczema This is an eczema which occurs in response to an oozing skin infection. The most common site is the foot /ankle region The causative organism is usu. Is staphylococccal or streptococcal Treat the infection When the skin is dry , use toipical stroid
  13. 13. Seborrhoeic eczema • Chronic inflammatory disease of the seborrehic areas • Clinically it is characterized by diffuse yellowish greasy scales • Dandruf is the mildest form of SD • Seborreahic areas are : - α Scalp α Retro auricular areas ,preauricular ,ear α Eye brows α Nasolabial folds α Upper chest α Interscapular areas – Armpits – Genital areas When severe
  14. 14. Pathogensis • Pityrosporium ovale is said to play a role in the pathogenesis • Increased sebum production (especillay in infants ) • SD has bimodal age occurecne • During infancy ( peak = 3/12) • Beyond puberty (peak = 4-7 decade) • Treatment • Topical antifungals / topical steroid • Systemic fluconazole
  15. 15. Treatment • ‘’If the lesion is wet , Dry it and if it is dry wet ‘’it . • ‘’Wet for wet and Dry for Dry lesions’’ • Acute eczema – Soak the lesions with antiseptics and drying agents like potassium permanganese 1 : 40000 – Topical steroids lotions /creams
  16. 16. Subacute eczema Topical stroids cearms or Ointments Chronic eczema Limit the use of soap Moisturizer including 5-10 % urea or lactic acid Topical stroids in Ointment form or with occlusion

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