Eczema (Greek ek: out, zeein: to boil) or dermatitis is a type of inflammation of the skin in response to various internal and external factors. It gets its name from the tiny fluid-filled blisters that form on the skin. Eczema is an important skin disease which, along with many other causes, arises largely from psychological factors. Eczema is very common in the population and has many subtypes. Medically called dermatitis, the disease is a skin condition commonly seen in children.
Eczema is a skin condition seen in about 10% of the population, appearing in areas of thin, sensitive skin, and especially often on exposed parts of the body such as the face, palms and soles. Eczema can be seen at any age. Although eczema is a bothersome and unsightly skin disease, it is not dangerous and can be controlled with simple treatment. Studies have found that one in every ten people has eczema at some point in their life. This rate rises to 50% in children in the first five years of life.
Eczema causes itching and an unsightly appearance on exposed parts of the body such as the hands, arms and face. In particular, people with eczema on their hands and feet are seriously limited in their daily activities.
Types of Eczema (Dermatitis)
Substances in contact with the skin can cause 2 types of dermatitis:
1. Irritant contact dermatitis
Irritant contact dermatitis is an inflammatory reaction produced in the skin by irritant substances that act by changing the skin's pH, moisture or structural integrity; it requires no special predisposition or sensitisation, can occur in anyone, and appears at most a few hours after contact with the irritant. The severity of the irritation is determined by the structure, thickness and moisture of the skin at the site of contact and whether it is an area of friction, as well as by the concentration of the substance and the duration of contact.
2. Allergic contact dermatitis
This is dermatitis that appears within 48-96 hours after an allergen comes into contact again with previously sensitised skin, developing as a delayed-type hypersensitivity reaction mediated by cellular immunity. In a sensitised person, successive flare-ups can occur even if the contact is very slight or brief.
The most common type of eczema is of allergic origin, known medically as atopic dermatitis. Eczema is also seen in most patients with allergic asthma and allergic rhinitis. Although eczema can be seen at any age, it is most common in young children and babies. However, as the child grows, the eczema usually clears on its own, and allergic asthma may take its place.
In nature there is a wide variety of allergens that are not protein in structure. Dyes, oils, resins, chemicals used in the textile industry, rubber, cosmetics, insecticides, plants, and products of bacteria, fungi and parasites can cause allergic contact dermatitis.
While allergic contact dermatitis is common in some areas of the body, other areas are particularly resistant to it. For example, allergic contact dermatitis is not seen on the scalp and palms except in special circumstances (for example, when irritant dermatitis is also present, or allergic contact dermatitis due to shampoos, hair dyes and sprays). In contrast, the eyelids, the area around the mouth, behind the ears, the neck, the inner wrists, the backs of the hands, the armpits, around the waist, the buttocks, the thighs, the perianal area, the external genitalia and the tops of the feet are areas where allergic contact dermatitis is common.
At what ages is eczema seen?
Most eczema seen in childhood is atopic eczema. In 85% of cases, atopic eczema starts in the first year of life (after the age of 2 months). Atopic eczema is found in 7-17% of children. Contact dermatitis, which accounts for about half of all eczema, is usually seen in adulthood. Dyshidrotic eczema, which accounts for 5-20% of all eczema, can be seen at any time between the ages of 4 and 76.
Is eczema contagious?
Because eczema is an allergic disease, it is not contagious.
What causes eczema?
The triggers of eczema are varied and differ according to the type of eczema. They may be external or internal.
Symptoms of eczema
Eczema is an inflammation occurring between the layers of the skin (a non-bacterial inflammatory condition, like oedema or irritation). The eczema area becomes red, may be moist or dry, and is usually itchy. If eczematous skin is scratched until it bleeds, infection may set in and serious inflammatory conditions may develop.
Eczema occurs on the face, neck, arms and legs, palms and soles, particularly where the skin folds or where clothes rub. The discomfort caused by the disease can vary in degree according to where the eczema affects the body, how extensive it is and whether there are cracks in the eczema. Eczema on the hands and feet limits the patient's movement.
How should a patient with eczema protect themselves?
* The eczema area should be protected from irritating substances. Those who have to work with such substances should protect themselves with simple measures such as rubber gloves and a face mask.
* It is enough to find the substance causing the allergy and for the patient to avoid the allergen from then on.
If there is eczema in infancy, cow's milk should be avoided. In cases where cow's milk is thought to be the underlying cause of the eczema, the baby should be breastfed and cow's milk should definitely not be given.
* Non-allergenic clothing for the child should also be considered, as eczema can develop depending on the type of clothing.
How is eczema diagnosed?
Eczema can usually be diagnosed by clinical examination. Where it is clinically confused with other diseases, a small piece of skin can be taken for pathological examination. A detailed history should be taken to identify the agents causing eczema in patients. Patch testing can be carried out to identify the substances causing allergic contact dermatitis. To demonstrate an allergic constitution, allergen-specific antibodies (specific IgE) can be measured in the blood.
Treatment
The main treatment for eczema is avoiding the agents causing the disease. For this, a detailed history should be taken and allergy tests carried out. Patients should avoid the allergens identified in these tests. However, it may not be possible to identify the responsible allergens in all patients.
The treatment of eczema varies according to its phase. In the weeping phase, drying paints and wet dressings are used; in the subacute phase, creams; and in the chronic phase, certain ointments. Moisturisers should be used for dryness, and certain anti-itch tablets should be taken for itching.