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Eczema, or eczema, is a group of skin diseases with similar symptoms but different causes. Eczema can be caused both by skin contact with a factor to which we are allergic, and by other mechanisms (irritation, seborrhea, problems with venous circulation). Eczema symptoms are also characteristic of allergic atopic dermatitis. Learn how to recognize eczema, where to look for its causes and what treatments are available.
Eczema , oreczema , is in fact inflammation of the superficial layers of the skin caused by a variety of factors. Regardless of the mechanism of formation, the appearance of skin lesions and the discomfort experienced by the patient have many common features.
The first characteristic symptom is persistent itching and redness of the skin. Lumps and bubbles appear on its surface.
The stronger the inflammatory reaction, the greater the severity of the symptoms - skin lesions may blend together and are often accompanied by inflammatory exudate.
These conditions may be accompanied by swelling and puffiness, especially in areas where the skin is relatively flaccid (for example around the eyes). In the case of eczema caused by toxic substances, there is pain in addition to itching.
Depending on the type of eczema, lesions may appear in different areas of the body.
Eczema is characterized by alternating periods of recovery and recurrence of symptoms.
Chronic eczema lesions cause exfoliation of the epidermis and dryness and thickening of the skin.
Eczema - types of eczema and mechanisms of formation
Eczema changes can arise from various types of reactions: contact with factors causing allergies or damaging the skin, as an expression of the body's response to infection or in connection with chronic diseases.
Different types of eczema can cause different symptoms. The most important types of eczema and the mechanisms of eczema formation are:
- allergic contact eczema
Contact eczema , also known as contact dermatitis, is caused by exposure of the skin to substances that cause an allergic reaction. Locationthe lesions are related to the area of the skin that has been in contact with the allergenic agent. Typically these are hands and forearms.
Contact allergy can be caused by various factors, most often chemical - metals (chrome, nickel, cob alt), rubbers and resins. We are often not aware of their presence in everyday items and products: cosmetics, jewelry, clothes.
Other common allergens include preservatives and dyes, as well as ingredients in topical medications (e.g. ointments).
Allergic eczema can also be caused by factors we come into contact with at work - then it is an occupational disease. It is a relatively common condition of industrial workers (contact with rubbers, paints, varnishes), hairdressers (cosmetics), as well as he alth care workers (allergy to latex).
In order to find out what specific substance causes this type of eczema, a so-called skin patch tests. Special tissues are placed on the skin of the back, soaked in substances that most often cause an allergic reaction. After 48 and 72 hours, skin observations are made - a positive test indicates allergy to a given reagent. We recognize it when redness and eczema appear at the point of contact.
- toxic contact eczema
This type of eczema is very similar to allergic contact eczema, but the mechanism of its formation is different. In this case, there is no allergic reaction. The cause of eczema lesions is direct skin irritation by a substance that is toxic to it.
Irritating eczema occurs in all people who deal with a harmful substance, not only in those who are allergic to it. Skin damage occurs only in the area that has been directly exposed to the toxic agent.
In case of allergic eczema, skin lesions may cover larger areas.
This type of eczema is most often caused by chemical (corrosive) cleaning agents.
- atopic eczema
Atopic dermatitis is characterized by the formation of eczema, which is the skin symptom of a genetic predisposition to an allergic reaction.
Eczema is not caused by direct skin contact with the sensitizing substance. The tendency to an allergic reaction in this case is an innate feature, and the factors causing it are most often food allergens (e.g. citrus) or inhaled allergens (e.g. grass pollen).
Atopic dermatitismay run in families.Skin changes may appear in early childhood. They often coexist with other allergic diseases (asthma, hay fever).
Typical localization of atopic lesions is the inner surface of the forearms, the back of the lower legs, the scalp and the hands. In infants, the changes are often found on the face.
Atopic skin has specific characteristics due to the destruction of its natural protective barrier. It is extremely dry, it is accompanied by persistent itching and hypersensitivity.
AZSis characterized by an alternating occurrence of exacerbations and the disappearance of skin lesions. In many cases, the disease resolves on its own.
- pimple eczema
The skin lesions in nematode eczema are round, sharply demarcated from the environment - hence the name of this type of eczema. Its origin is unclear, however it is suspected to be associated with bacterial or fungal infections.
Eczema is more common in the elderly, it tends to recur and is characterized by severe itching. The lesions usually appear on the lower legs, torso, and arms.
- sweat eczema
Eczema occurs only on the hands and feet. The skin becomes blistered and itchy. The changes may worsen on warm days. Sweating eczema can be a form of contact allergy, sometimes it also coexists with athlete's foot. It is then an expression of hypersensitivity to fungal allergens.
- seborrheic eczema
Seborrheic eczema - seborrheic dermatitis - occurs in areas of increased sebum production, which tend to be oily. These include: a hairy scalp, face and (less commonly) torso. These changes can also occur in infants in the first weeks of life. In addition to the typical features of eczema (redness, papules), they are often accompanied by exudate that dries up on the skin in the form of yellowish scabs. On the hairy scalp, the changes are very similar to dandruff. In addition to seborrhea itself, eczema can be aggravated by a yeast infection of the skin.
- lower leg eczema
This type of eczema has a completely different background from the others - it is caused by impaired venous circulation. It occurs typically in the elderly on the lower legs. It usually coexists with venous insufficiency, varicose veins and leg ulcers.
Eczema treatment
In order to select an effective type of therapy for skin lesions in eczema, it is necessary to know the causes of ituprising. If you can identify a factor that causes eczema in contact with the skin, you should simply avoid it in the world.
Topical ointments with the addition of corticosteroids are usually effective. If the doctor suspects superinfection of skin lesions, he may additionally prescribe antibacterial or antifungal agents.
Oral corticosteroids are also given when eczema affects large areas of the body. Oral antiallergic (antihistamines) medications are also commonly used.
Different treatment rules apply to atopic eczema. It is of key importance to care for the skin with emollients, i.e. moisturizing agents. Their task is to prevent the skin from drying out. Topical steroid ointments are also used, as well as drugs from the group of the so-called calcineurin inhibitors.
Another type of therapy is irradiation with ultraviolet UVA and UVB rays (phototherapy).
Finally, in the absence of a response to all of the above forms of treatment, oral immunosuppressive treatment is introduced to suppress an overly reactive immune system. The most commonly used immunosuppressants are cyclosporine and azathioprine.
If eczema is likely to be infectious, it is worth implementing additional antimicrobial treatment. For example, in seborrheic eczema, which is often associated with yeast infections, topical antifungal medications (such as ketoconazole) are used.
The causal treatment of leg eczema requires measures to strengthen the vascular walls and improve venous circulation.
