What is Eczema
Also it is known as dermatitis, since eczema is a skin disease. Being called also Atopic Dermatitis (AD), eczema is characterized by very dry and itchy skin, and it is a non-contagious skin inflammation. Usually, it develops due to allergies caused by food or inhalants. It is a psychosomatic and unsightly dermatitis which have acute, chronic, wet and dry clinical forms, and have a clinical course with several symptoms such as; redness, swelling, itching on the skin. It is a fact that disease occur among ten people in a hundred. In addition to itching and discomfortness, eczema also cause an unsightly appearance on exposed areas like hand, arm and face. Eczema is not a contagious disease.
The most common form is plaque-like psoriasis on the skin and characterized by redness, flaking and desquamation especially on the knee, elbow, dorsum and coccyx called as the sacrum. Psoriasis may exhibit different manifestations in children, adults and elders. While the only red flaking is the psoriatic symptoms in children, adult population experience all symptoms of the disease.
Skin symptoms are characterized by well-shaped, rosy patches covered with silvery plaque on the surface. This lesion is a dry formation, and characterized by areas of pint point bleeding when it is scraped. When you rub the skin with your hand, lesions will peel like dust. Small nail pitting can also appear, and the nail will be separated from nail fold. Thickened or broken nails can show up. Lesions can also occur in the inguinal region, axilla (armpit) and genital area.
Though cause of psoriasis is not fully understood, it is considered that disease can occur as a result of an abnormality in the white blood cells. In researches, it is determined that immune system is stimulated by several causes (stress, medication, infection), and this process accelerates the growth of skin cells. Maturation of normal skin cells takes time nearly 28-30 days, but this period can drop to 3-4 days in psoriasis patients. Thus, proliferating cells accumulates on the surface and yields to a thick plaque.
During the disease process, following an inflammation, adesquamation phase occurs. Changes in skin metabolism ¬is a result of disease rather than being a cause. Risk for psoriasis development is increased in some conditions such as; injury, trauma, rheumatic fever, certain diseases with a microorganism ethology. In addition, cancer and immunosuppressant medications, used for the conditions such as; organ transplantation, yield also to an increased risk of psoriasis.
Psychological factors such as stress, tension, lack of love and the mother – child relationship disorders may ensure development or exacerbation of psoriasis. Additionally, hypocalcaemia and hormonal effects are considered to be influential for development of psoriasis.
Eczema (dermatitis) is one of the most common skin disease, but it also a kind of disease of which causes and treatment is still fuzzy in medical world. In course of eczema, skin reacts by inflammation induced by internal or environmental factors through immune system. It is a condition that causes itching, rashes, redness, dryness and cracking. There are various types of eczema, such as; neurological, allergic, oily skin and contact eczema. The most common type is allergic eczema, which is also known as atopic dermatitis, and is considered to be more hereditary. Patients usually experience similar symptoms. Most common complaints are blistering of skin, irritation and itching.
Some types of eczema, for example contact eczema, develop depending on a single cause, other types of eczema may be occur depending on a combination of several factors. Childhood eczema may resolve spontaneously over time but there is no definitive therapy of eczema in adults. Eczema can be restrained by avoiding from the triggering factors.
Eczema can be developed due to anything that irritates the skin. For example, in the event of contact eczema (contact dermatitis); skin gets more sensitive against several mildly or powerful irritants such as; soap, shampoo, detergent, bleacher, when being exposed continuously. Even if a constant exposure is not occur, sometimes the skin may react to a substance which makes skin dry and take skin’s oil away. May be sound in that way, but this type is not an allergic eczema, it is the contact eczema. It leads to redness, dryness, cracking and itching on the skin. .
Allergic eczema is caused by allergens such as poison ivy. Metals similar to nickel are one of the allergens that cause eczema. Eczema caused by allergens usually occurs in childhood and in some cases it is transported into adulthood. Food allergies, milk, eggs and peanuts can cause eczema among children, while house dust, certain bacteria, pets like cat and dog can also leads to eczema among both children and adults. Allergic contact eczema usually arise due to nickel jewellery, cosmetics, hair dye or substances in perfume, construction materials such as; rubber, cement, solvents and adhesives.
One of environmental factors that trigger eczema is climate. Complaints increase in winters with cold and low humidity air condition. Mid seasons, cold weather or amount of humidity in the air can exacerbate eczema, but those are not an underlying main reason.
Just like allergic eczema, certain types of eczema have a family history (diagnosed in mother or father or both), and genes can be effective by 60% – 80% in rate of emergence of childhood eczema. In case a genetic predisposition, eczema emerges, as being triggered by environmental factors. However, eczema does not depend on a single gene. Immune system plays a major role in the development of eczema, and many of genes are influential on immune system.
Immune system plays a significant role in development and recurrence of eczema. Due to reaction against allergy, level of cytokines are increased in people who suffer from atopic dermatitis (allergic eczema), which is the most common form of eczema. Cytokines are proteins, secreted by cells of immune system. In people, who have high cytokine levels due to allergic reaction, inflammation of the skin can be seen even if an infection does not occur.
Stressed and anxious mood lead to multiple complaints and unfortunately. Those effects are not limited to mental deterioration, also physically deterioration can occur too. One of these complaints is stress eczema. Our brain can not distinguish what caused stress and fear. The one who has constantly issues on business life and the one who has faced with a wild animal in a jungle, both are indistinguishable for the brain. In any case, brain will react by thinking that the body is in danger. However, the body is not programmed for being under stress the whole day. Therefore, being on constantly alert mood will overstrain body, and physical reflection of the stress will be emerged.
Namely dermatitis, eczema is characterized by epidermal oedema (spongiosis). Predominant types of eczema are allergic contact dermatitis and primer irritant contact-dermatitis. Other types of eczema are atopic dermatitis, seborrheic dermatitis, discoid eczema and lichen simplex chronicus.
Atopic dermatitis usually occurs among children, and it is a rare, recurrent, itchy condition. There is a tendency to occur within the family members, and it is believed many genes are involved. The disease is often associated with asthma and pollinosis. Eczema-excoriation and lichenification, generalized xeroderma on flexor surfaces are clinical features of atopic dermatitis.
Topical corticosteroids are the most effective topical agents, but they cause skin thinning, suppression of pituitary-adrenal axis and a rebound after discontinuation.
Seboraic dermatitis shows up on scalp, flexor surfaces and middle body. On the face, pink spots with excessive dandruff and flaking on the skinfolds are characteristic. It is highly common among elders, particularly on their large flexor surfaces.
Discoid eczema shows up especially among middle-aged and elders. It is characterized by round and red scaly lesions. It needs to be distinguished from psoriasis and Bowen’s disease. For treatment, moisturizer and corticosteroid are used.
Eczema Craquelin (asteatotic eczema) shows up among elders, particularly on the dry surface of leg and is characterized by a red rash in the form of a strange tile.
Lichen simplex chronicus is an itchy dermatitis, which occur on the inner side of ankles and the dorsal side of neck. On the affected areas, well-defined, raised, red excoriate and lichenified areas can be seen. The disease is very persistent, but highly efficient topical corticosteroids may be useful.
Venous eczema occurs on the lower legs of elderly patients with venous hypertension. It is considered that those patients have an allergic contact dermatitis against substances used in the treatment of venous ulcers.