Revisit on skin diseases: eczema (3) – The Nation Newspaper

Dr Joel Akande

Let me clarify a common misconception immediately now. To medical doctors, eczema is a distinct skin illness. This is different from what the general public considers as eczema. In the perception of the public, eczema covers practically all common skin diseases.

This should not be so. On the other hand, eczema and dermatitis are frequently used as if they mean the same thing. First, dermatosis. Dermatosis means any skin disease. Dermatitis means inflammation of the skin as measured by swelling, heat generation, pain and change in colour.

What is Eczema? Coming from the Greek word, ekzein, eczema means to boil out as a result of the evolution of the skin changes under eczema.

Eczema, therefore, has the following characteristics: rashes (macules for example), redness, crusting of skin, oedema or swelling, thickening of the skin due to repeated and frequent rubbing of or scratching of the skin and finally changes in the skin colour.

We should not forget that the disposition of the individual to develop eczema is equally important. The changes in colour and thickening occur at a later development or weeks after the initial changes as mentioned above. The first is acute and the second is called chronic eczema.

Types of Eczema: I will only mention here that eczema can be classified as endogenous (internal) or exogenous (internal). Of the internal, atopic eczema is perhaps the commonest. I will discuss a brief of this condition later as its seen in a lot of ways in children.

Seborrhoeic dermatitis seen frequently on the scalp of children and women is also common. Other conditions are discoid eczema, pompholyx and peeling skin syndrome. For exogenous eczema, hand dermatitis, irritant dermatitis, photo dermatitis, infective eczema, allergic contact dermatitis, exfoliative and perioral dermatitis are common examples.

I will now discuss a few of the common forms of eczema amongst our population.

Atopic eczema (dermatitis): This is a common illness and is said to account for about 20 per cent of skin disorders seen at skin clinics.

Children fed on cows milk rather than on breast milk are more likely to develop atopic eczema. Children fed on mixed breast and cows milk are also at risk.

Causes of atopic eczema: The human body reacts to intolerable agent internally but later shows up in the skin. Some diseases such as deficiency in some vitamins (biotin), cystic fibrosis may lead to eczema. Atopic eczema may also develop due to infections such as staphylococcus infection.

How does atopic eczema present? Children, infants and adults are affected. And it can show up as early as 2 weeks of life.

There are patches in both sides of the body especially on the joints of elbows, behind the knees, cheeks and forehead. Widespread dry skin involvement may occur. Itching and scratching, dryness of the skin, crusting are present.

The skin become thickened and may become infected. The face may be affected too. By age of 2-3 years, the eczema may or may not disappear only to reappear later in childhood and adulthood.

Treatment: Information and knowledge is power. Its important that adult victims and parents of children should get as much knowledge and information about the eczema as much as possible.

Atopic eczema requires intervention of specialist dermatologist. The medical doctor will endeavor to contain troublesome itching as well as ensuring the dry crusted skin remain moist.

Doctors are also likely to pay attention to curtailing inflammation and preventing occurrence of underlying causes.

Other common and important eczematous forms are contact dermatitis.

This indicates that there are agents that the sufferers have been in contact with that are ultimately responsible for the eczema now being suffered. Seborrhoeic dermatitis is common and will require a physicians attention.

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Revisit on skin diseases: eczema (3) - The Nation Newspaper