Atopic Eczema

Dermatology

Clinicals - History

Fact Explanation
Itching. Due to the release of histamine and cytokines which bind to specific receptors which in turn excite the free nerve endings in the cutaneous nerve fibers . Itching.
Due to the release of histamine and cytokines which bind to specific receptors which in turn excite the free nerve endings in the cutaneous nerve fibers .
Sleep disturbance. Due to severe nocturnal itching . Sleep disturbance.
Due to severe nocturnal itching .
Commonly affects face, back of knees, antecubital fossae and wrists. The degree of thickness in the stratum corneum in these areas favors the development of atopic eczema, as does the variation in exposure to irritants and allergens as compared to other body sites . Commonly affects face, back of knees, antecubital fossae and wrists.
The degree of thickness in the stratum corneum in these areas favors the development of atopic eczema, as does the variation in exposure to irritants and allergens as compared to other body sites .
History of asthma, hay fever, etc. Atopy is a common syndrome underlying asthma, rhinitis, and eczema, and is characterised by high immunoglobulin E (IgE) responses to common antigens . History of asthma, hay fever, etc.
Atopy is a common syndrome underlying asthma, rhinitis, and eczema, and is characterised by high immunoglobulin E (IgE) responses to common antigens .
Positive family history. A link has been reported between atopy and chromosome 11 . Positive family history.
A link has been reported between atopy and chromosome 11 .

Clinicals - Examination

Fact Explanation
Skin excoriation. Due to the intense scratching . Skin excoriation.
Due to the intense scratching .
Erythema. Due to the associated inflammatory response . Erythema.
Due to the associated inflammatory response .
Edema. Due to the associated inflammatory response . Edema.
Due to the associated inflammatory response .
Lichenification. Due to the chronic tissue damage caused by the scratching . Lichenification.
Due to the chronic tissue damage caused by the scratching .
Oozing lesions. When complicated by acute bacterial infection . Oozing lesions.
When complicated by acute bacterial infection .

Investigations - Diagnosis

Fact Explanation
Serum IgE levels. There is atopic sensitization with excessive production of IgE in atopic eczema . Serum IgE levels.
There is atopic sensitization with excessive production of IgE in atopic eczema .
Atopy patch test. A patch containing allergens known to induce IgE mediated sensitization is applied to the skin in order to observe a reaction . Atopy patch test.
A patch containing allergens known to induce IgE mediated sensitization is applied to the skin in order to observe a reaction .
Skin swabs for microbiological culture from affected areas. To identify atopic eczema that is complicated by bacterial infection . Skin swabs for microbiological culture from affected areas.
To identify atopic eczema that is complicated by bacterial infection .

Management - Supportive

Fact Explanation
Identify and avoid triggers. Due to the genetic influence, certain environmental factors could provoke and aggravate the condition . Identify and avoid triggers.
Due to the genetic influence, certain environmental factors could provoke and aggravate the condition .
Emollients. Dry skin is accompanied by changes in the stratum corneum which in turn increases the susceptibility to develop atopic eczema. Emollients act by inhibiting transepidermal water loss by occlusion, attracting water to stratum corneum (humectant) and rejuvinating skin by replenishing its essential proteins . Emollients.
Dry skin is accompanied by changes in the stratum corneum which in turn increases the susceptibility to develop atopic eczema. Emollients act by inhibiting transepidermal water loss by occlusion, attracting water to stratum corneum (humectant) and rejuvinating skin by replenishing its essential proteins .
Antihistamines. It provides syptomatic relief at night from itching associated with histamine release . Antihistamines.
It provides syptomatic relief at night from itching associated with histamine release .

Management - Specific

Fact Explanation
Topical corticosteroids. Due to its strong anti-inflammotory effect on the affected area of skin . Topical corticosteroids.
Due to its strong anti-inflammotory effect on the affected area of skin .
Photochemotherapy (PUVA). It is known have a strong immnunomodulating capacity . Photochemotherapy (PUVA).
It is known have a strong immnunomodulating capacity .
Antimicrobials. When complicated with bacterial infection . Antimicrobials.
When complicated with bacterial infection .

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