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Signs and symptoms of eczema: Atopic dermatitis (eczema) – Symptoms and causes

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Eczema types: Atopic dermatitis symptoms

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Atopic eczema – Symptoms – NHS

Atopic eczema causes areas of skin to become itchy, dry, cracked and sore.

There are usually periods where the symptoms improve, followed by periods where they get worse (flare-ups). Flare-ups may occur as often as 2 or 3 times a month.

Atopic eczema can occur all over the body, but is most common on the hands (especially fingers), the insides of the elbows or backs of the knees, and the face and scalp in children.

Eczema on the ankle.

Credit:

DR P. MARAZZI/SCIENCE PHOTO LIBRARY https://www. sciencephoto.com/media/256384/view

Eczema on the back of the knees.

Credit:

SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/494292/view

The severity of atopic eczema can vary a lot from person to person. People with mild eczema may only have small areas of dry skin that are occasionally itchy. In more severe cases, atopic eczema can cause widespread inflamed skin all over the body and constant itching.

Inflamed skin can become red on lighter skin, and darker brown, purple or grey on darker skin. This can also be more difficult to see on darker skin.

Scratching can disrupt your sleep, make your skin bleed, and cause secondary infections. It can also make itching worse, and a cycle of itching and regular scratching may develop. This can lead to sleepless nights and difficulty concentrating at school or work.

Areas of skin affected by eczema may also turn temporarily darker or lighter after the condition has improved. This is more noticeable in people with darker skin. It’s not a result of scarring or a side effect of steroid creams, but more of a “footprint” of old inflammation and eventually skin tone returns to its normal colour.

Occasionally, areas of skin affected by atopic eczema can become infected. Signs of an infection can include:

  • your eczema getting a lot worse
  • fluid oozing from the skin
  • a yellow crust on the skin surface or small yellowish-white spots appearing in the eczema
  • the skin becoming swollen and sore
  • feeling hot and shivery and generally feeling unwell

See a doctor as soon as possible if you think your or your child’s skin may have become infected.

Read more about infections and other complications of atopic eczema

Page last reviewed: 05 December 2019
Next review due: 05 December 2022

causes, what it looks like, types, stages, symptoms, diagnosis, treatment

Causes

Classification

Symptoms

Complications

Diagnosis

Treatment

Prevention and prognosis

Eczema is an inflammation of the skin of a non-infectious nature. Among the main manifestations are redness and itchy blisters that contain fluid. May become chronic. The name “eczema” comes from the word “boil”, and it came from the fact that the bubbles in this disease are similar to those that appear in boiling water.

Eczema can occur on the hands, feet, face. The disease can appear regardless of age and gender, but women are more susceptible to it. The reasons for this are unknown, perhaps it is due to the hormonal background or more frequent contact with household chemicals. Most often it has a professional nature: when the skin is constantly exposed to chemicals, allergens, especially against the background of a weakened immune system.

Eczema is not contagious and is not transmitted to other people, since microorganisms do not participate in its development.

Causes and triggers

It is now established that the cause of eczema is primarily hidden in genetics: a predisposition to it is inherited. If one of the parents has this disease, then the probability of its occurrence in children is up to 40%, and if two parents have it, up to 60%.

With a large number of synthetic substances in the modern world, from household chemicals to food additives, as well as allergens, stress, the likelihood of eczema with a genetic predisposition is very high. Moreover, in such cases, severe forms often occur, which are difficult to treat and give complications.

However, in order for the disease to manifest itself even with a predisposition, the influence of some predisposing factors is required, including:

  • existing allergy to household chemicals, dust or other substances;
  • endocrine diseases;
  • regular stress, neurotic conditions;
  • chronic inflammatory processes of infectious origin, including caries;
  • chronic diseases of internal organs – liver, stomach, intestines and others;
  • avitaminosis;
  • hormonal disruptions during puberty, menopause, against the background of taking medications and other treatment.

    • If a person has any of the above, this does not guarantee manifestations of eczema. However, some factors can cause its appearance at any time, for example, hypothermia, trauma with skin damage, alcohol consumption, contact with chemicals, including cosmetics, or those that are part of food, severe stress and anxiety.

    The disease begins when an autoimmune reaction is triggered, that is, the body produces antibodies against skin cells. This occurs when several factors are combined at once: predisposition, contact with chemicals, the action of antigens from chronic infectious foci, against the background of a decrease in immunity. As a result of autoimmune processes, inflammation appears on the skin with characteristic watery vesicles.

    Classification

    There are different forms of eczema that can vary greatly, and here are a few of the most common:

    1. True. It usually appears on the face and limbs. The affected areas of uneven shape alternate with healthy ones, have vesicular vesicles, papules, pustules. The skin turns red, weeping erosions form on it. In the chronic form, the skin coarsens, becomes dry, abscesses may appear when combed erosions become infected.
    2. Nummular or nummular eczema. It is provoked mainly by allergic reactions and chronic infectious processes in the oral cavity or respiratory system. It looks like coin-shaped plaques 1-3 cm in diameter, with vesicles, areas of wetting, crusts. In women, it usually occurs during puberty, and in men – closer to 60 years.
    3. Microbial eczema. Usually occurs around infected wounds or areas of pyoderma. May have a different shape with a clear border. In the center, purulent or serous crusts appear, when peeled off, areas of weeping are exposed. Itching is strongly pronounced, which provokes infection of the affected areas.
    4. seborrheic eczema. It starts on the head under the hair, in places where the sebaceous glands accumulate. Then it moves to other areas of the body. The skin is hyperemic, edematous, with yellow papules and covered with yellow crusts.
    5. Varicose eczema. It develops against the background of varicose veins, on the legs, near varicose ulcers. Severe itching is characteristic.
    6. sycosiform form. It is formed during infection and inflammation of the hair follicles and spreads beyond the hairline. It occurs on the face, under the armpits, on the pubis. This form is characterized by weeping and severe itching.
    7. Dyshidrotic eczema. It affects the skin of the palms and feet, where hyperemic areas appear with small bubbles containing liquid.
    8. Professional. Occurs due to the influence of production factors. Usually this is frequent contact with allergens – chemicals, antibiotics, metals. It often happens to those who often immerse their hands in water: dishwashers, cooks, cleaners, orderlies. It manifests itself in the contact zone as true eczema and disappears if the irritating factor is removed, for example, to change jobs.
    9. Dry eczema. It usually appears in older people on the background of too dry skin. Usually affects the hands or feet, and not only the epidermis, but also the dermis. It is manifested by redness, the formation of papules, peeling, ulcers. Severe itching, soreness, burning sensation are characteristic.

    Eczema in children also occurs, children from the age of 3 months can get sick. In them, the disease can affect any area of ​​\u200b\u200bthe head, except for the nasolabial triangle, as well as the buttocks and limbs.

    The disease goes through several stages of development: first there is hyperemia of the skin, itching, then papules form, then vesicles with fluid and weeping when they open. This is the stage of weeping eczema, when infection of the affected skin is possible. Then these areas dry up and crusts form. Further, the crusts are exfoliated, the skin is restored.

    Symptoms

    Symptoms of different forms of eczema are somewhat different, but they are also characterized by common manifestations:

    • skin redness, swelling;
    • the formation of vesicles with vesicular contents;
    • severe itching.

    Also, this pathology is characterized by the opening of vesicles and the formation of crusts, under which areas of weeping are noticeable. At the stage of recovery, these crusts begin to peel off.

    Complications

    Pathology can be complicated by the addition of an infection. Then the affected areas can fester and symptoms of intoxication will appear, with an increase in temperature and a deterioration in well-being. Infection can cause ulceration of the skin, which can visibly damage a person’s appearance.

    The most dangerous complication is erythroderma, when inflammation covers 90% of the skin. This disease has a high mortality rate.

    Diagnosis

    To diagnose eczema, a dermatologist conducts an examination and questioning whether a person has relatives with this disease, allergic reactions, and type of activity. Skin hyperemia, erosion, gray crusts and weeping allow a preliminary diagnosis, but some research may be required.

    Among them:

    • biochemical blood test;
    • blood test for immunoglobulin E;
    • sowing discharge to identify microorganisms and determine their sensitivity to antibiotics – to exclude the microbial form and treat secondary infections.

    You may also need to consult other specialists: an endocrinologist, a gastroenterologist, a psychoneurologist.

    Treatment

    For the treatment of eczema, an individual approach is required, since it is necessary first of all to eliminate the provoking factors. A hypoallergenic diet is prescribed, with the exception of foods such as fish, fatty meats, cocoa and coffee, citrus fruits, and legumes.

    If the disease is caused by external factors, they should be eliminated: move to a more environmentally friendly place, change jobs, exclude contact with disease-provoking factors, including at home.

    The following drugs are also used to treat eczema:

    • antihistamines – to reduce itching;
    • desensitizing – to stop inflammation and normalize metabolic processes in the skin;
    • glucocorticosteroids – with volumetric weeping eczema or the absence of results from treatment with other drugs;
    • antibiotics – if a microbial form is detected or a secondary infection has joined.

    Immunostimulating drugs may also be prescribed to increase the body’s defenses. Along the way, the therapy of the underlying disease should be carried out, if this has been detected, and first of all, the pathologies of the gastrointestinal tract. It is possible to prescribe sedatives to normalize the central nervous system.

    Lotions with astringents can be used locally – this accelerates the formation of crusts and their drying. Ointments and creams for eczema based on corticosteroids and antiseptics have also proven effective.

    Prevention and prognosis

    With proper and timely treatment, after a few days, itching and inflammation are noticeably reduced. Recovery occurs in 3-4 weeks, so the prognosis for uncomplicated forms of eczema is favorable. In the complicated form, it depends on the accompanying problems and the possibilities for their treatment.

    For the prevention of eczema, hygiene rules should be observed and contact with allergens should be avoided. Proper skin care is also important – keeping it clean, using emollients and moisturizers, but damage and the use of harsh products should be avoided.

    The author of the article:

    Shapovalova Valeria Olegovna

    cosmetologist, dermatologist, trichologist

    work experience 7 years

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