Atopic eczema is a chronic and relapsing inflammatory skin condition characterized by an itchy red rash, particularly in skin creases. Common triggers include irritants, skin infections, allergens, and environmental factors such as temperature extremes. Diagnosis may involve immunoglobulin E testing and bacterial swabs to assess treatment resistance.

1. ATOPIC ECZEMA
By- Dr. Armaan Singh

2. Atopic eczema is a chronic,
relapsing, inflammatory skin
condition characterised by an
itchy red rash that favours the
skin creases such as the folds
of the elbows or behind the
knees.

3. TRIGGER FACTORS
O Irritants, eg soaps and detergents (including shampoos, bubble baths,
shower gels and washing-up liquids).
O Skin infections: Staphylococcus aureus is believed to be an important
exacerbating factor in atopic eczema.
O Contact allergens.
O Extremes of temperature and humidity. Most patients improve in
summer and are worse in winter. Sweating induced by heat or exercise
can provoke an exacerbation.[
-
O Abrasive fabrics, eg wool.
O Dietary factors aggravate atopic eczema in about 10% of children but
much less frequently in adults.Food allergy should be suspected in
children with atopic eczema who have reacted previously to a food, with
immediate symptoms, or in infants and young children with moderate or
severe atopic eczema that has not been controlled by optimum
management, particularly if associated with gut dysmotility (colic,
vomiting, altered bowel habit) or failure to thrive.
O Stress may exacerbate atopic eczema, which itself may be a cause of
psychological distress.
O Hormonal changes in women - eg premenstrual flare-ups, deterioration in
pregnancy.

4. DIFFERENTIAL DIAGNOSIS
O Psoriasis
O Contact dermatitis
O Seborrhoeic dermatitis
O Fungal infections
O Lichen simplex chronicus
O Scabies and other infestations

5. INVESTIGATIONS
O Estimation of immunoglobulin E (IgE) and
specific radio allergosorbant tests (RASTs) only
confirm the atopic nature of the individual.
O Swabs for bacteriology are particularly useful if
patients do not respond to treatment, in order
to identify antibiotic-resistant strains of S.
aureus or to detect additiona lstreptococcal
infection.

6. INVESTIGATIONS
O Estimation of immunoglobulin E (IgE) and
specific radio allergosorbant tests (RASTs) only
confirm the atopic nature of the individual.
O Swabs for bacteriology are particularly useful if
patients do not respond to treatment, in order
to identify antibiotic-resistant strains of S.
aureus or to detect additiona lstreptococcal
infection.