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What is eczema?

What is eczema?

Eczema English called Eczema or Dermatitis is one of the most common skin diseases. and have different names

Disease mechanism

It was found that the inflammatory reaction occurred on the skin at various locations such as the face, limbs, and torso, depending on the case. The inflammatory reaction that occurs in one person may be different from another.

What is eczema?

Eczema is an inflammatory skin condition that occurs It can be for several reasons. It usually comes with a rash, swelling or redness on the skin. But in some cases, it may cause blisters, pus, or a scab. The most common inflammatory skin conditions are atopic dermatitis, seborrheic dermatitis, and contact dermatitis. However, this condition is not contagious to others. But it may cause an itchy or irritated feeling. and lose confidence because of abnormal skin appearance

Causes of dermatitis

Inflammatory dermatitis can be caused by a variety of causes, such as atopic dermatitis, seborrhea, and contact dermatitis, among others. family history of this group of diseases), diet, and environment, etc. The risk factors for each disease can be divided as follows:

1. Atopic Dermatitis

This type of dermatitis At present, it is assumed that there are many factors in common such as dry skin, genetics, immune system disorders. bacteria on the skin and living environment, etc.

2. Allergic Contact Dermatitis

contact dermatitis The skin comes in contact with a specific type of irritant or allergen, such as certain metals, cleaning products, perfumes, hair dyes, cosmetics, or skin creams. Including eating certain foods such as seafood, fermented food, etc.

3. Seborrheic Dermatitis

Seb dermatitis At present, the exact cause is unknown. It is believed to be caused by a number of factors, such as fungal infections that live in oil on the skin. Especially on the scalp and face, diet and season, etc.

4. Other inflammatory skin diseases

There are also other inflammatory skin diseases such as Nummular Eczema, Lichen Simplex Chronicus, Dyshidrotic Eczema, and Stasis Dermatitis, etc. There are also different triggering factors.

Symptoms of dermatitis

Symptoms of eczema There will be differences in each patient. depending on the stage of the disease and types of eczema Roughly divided as follows:

Acute eczema (acute eczema)

in this acute period new rash The skin will have a characteristic of inflammation, that is, there will be a red rash, itching, the skin around the rash will be swollen. and a small clear blister formed

2. Subacute Eczema

At this stage, skin rashes have been around for some time. Begin to see clear lymph fluid coming out of the rash. Then the oozing lymph from the rash gradually decreases, the rash dries up, and it looks like a scaly rash. But still have the same itching.

3. Chronic eczema

In this phase, it starts with eczema rashes that continue for a long time or chronically. Combined with repeated scratching from itching. The rash that is found will become thick, dry, hard, with clear lines of the skin. and the color of the skin is darker

Diagnosis of dermatitis

Your doctor can diagnose eczema by taking a history. and physical examination to look at the appearance of the patient’s skin rash But sometimes if the rash is unclear in nature or the doctor suspects other diseases will be sent for laboratory testing Including the collection of skin biopsies for further examination. To isolate the cause from other skin diseases

In addition, if the doctor suspects This dermatitis is also caused by contact dermatitis. Patients may be tested for skin allergens. to see if the allergic reaction is caused by an irritant or any type of allergy stimulant Most young patients may be likely to need allergy testing. The examination will be a specific dermatological examination called “Patch test” to see what / which substance causes the skin to be allergic.

Treatment of dermatitis

Use of medications for dermatitis medical

Group of topical drugs or topical creams for the treatment of dermatitis

• corticosteroid topical medication (Corticosteroids) Ointments in this group come in the form of creams, lotions, and ointments. This group of ointments will help reduce inflammation. allergy relief and itching There are many types. from low to very strong strength to choose from
• Ointments that suppress the body’s immune system (Calcineurin Inhibitor). Ointments in this group are available in the form of creams and ointments. It is a drug that helps fight skin inflammation. and reduce the immune response of the skin This causes itching and redness on the skin. But should not be used in children under 2 years of age.
• Rich moisturizing cream Your doctor may prescribe a special moisturizer. To help increase moisture and nourish the skin specially.

Skin oil group Reduces skin water loss and moisturizes the skin

Group of oral drugs for the treatment of dermatitis

• Antihistamines are mostly drugs in the group. Antihistamines such as chlorpheniramine or CPM There are several drugs in this group. Each has some different advantages and disadvantages. Helps relieve allergies and itching. Available at general pharmacies. But should be used carefully. Because some antihistamines can cause drowsiness.
• oral corticosteroid drugs (Corticosteroids) Oral medications in this group are used in patients with severe symptoms. Reduces inflammation of the skin Relieves swelling and itching The drugs in this group can only be prescribed at the discretion of the physician.
• Antiseptics. Sometimes antibiotics are used. or disinfectants together In cases where skin infections are suspected, such as in patients who scratch until the wound becomes infected
  treatment for other groups

artificial solar irradiation It is the use of ultraviolet radiation to help treat eczema. It is often used in patients with severe disease. or does not respond to other treatments mentioned above

Self-Care for Eczema

Self-care of this group of diseases will focus on prevention and alleviation of itching. Because dermatitis results in dry and itchy skin, scratching can lead to ulcers. and eventually lead to skin infections By self-care used in atopic dermatitis:

1. Avoid rubbing or scratching the rash and itchy skin. Patients should wear clothing that can cover the itchy area. To prevent the occurrence of abrasions from scratching hard. and should cut nails or wear gloves while sleeping
2. Wear clothing made of cotton. The smooth, soft surface of the cotton cloth will prevent irritation of the inflamed skin.
3. Choose a gentle and odorless laundry detergent. To prevent contact rash which is one of the causes of dermatitis Including avoiding soap and any harsh detergents. which may cause irritation to the skin
4. Moisturize your skin regularly with a cream or ointment moisturizer. to create a protective layer against moisture loss Help reduce dry skin. Reduce the severity of allergic rashes However, for those with mild symptoms, moisturizers may still be used as the main treatment.
5. avoid allergens Especially patients with contact dermatitis You should protect your skin from exposure to substances that are particularly irritating.
6. Reduce stress, for example, find activities to relax. exercise Because stress can be one of the factors that trigger certain types of dermatitis.
   Side effects of eczema
7. Because eczema rashes are often very itchy. Excessive and severe scratching May cause side effects are Complicated bacterial infection of the skin.

How to prevent dermatitis

• Prevention of eczema can be done by
• Avoid contact with allergens such as chemicals.
• Use gentle skin care products. To reduce the chance of developing dermatitis caused by contact allergies
• Moisturize your skin with this moisturizing cream. (Moisturizer) regularly to reduce the chance of skin irritation.
• Observe daily life both at home and at work. What’s the trigger? or causing irritation to the skin (including food and drink) in order to avoid them
• Control the disease that causes eczema well.

treatment guidelines

• Guidelines for the treatment of acute eczema Use a salt water compress or Burrow solution 1:40 or 3% boric acid solution 3-4 times a day. Stop the compress when the rash has dried. otherwise it will be too dry make it tight and break
• medium term Consider using a steroid ointment. according to the nature and location of the rash
• in the chronic stage Use a steroid ointment mixed with Salicylic acid to help the rash heal faster.
• for itching Take an oral antihistamine such as incidal or atarax. Be aware of the drowsiness associated with these drugs. Avoid driving vehicles and doing work that poses a risk to
• Accidents and sharp objects

Some advice for patients

• Prevent your hands from touching anything irritating. or suspected to be allergic, such as soap, detergent
• Refrain from washing your hair by yourself. or wear gloves, do not apply hair conditioner, hair dye
• Avoid handwashing or frequent handwashing.
• Avoid peeling or squeezing the fruit.
• do not wear a ring while working
• Use mild soap to wash your hands.
• Once cured, the work should be stopped for a while.

References and sources

Preeya Kullawanich, Prawit Bisayabutr. Dermatology 2020: First Edition. Bangkok: Holistic ,2012

Dr. Chindanai Vikraiphat and Dr. Pattama Paparakon met M.Sc. Dermatology (Dr. Chin-Dr. Liu), dermatologist at LC Clinic.