ECZEMA

Eczema is typically red, scaly, itchy with an irregular surface, and ill-defined.

An adult man with diffuse asteatotic eczema. The skin is red, rough, scaly and itchy.

Key Points

• Eczema is a broad term used to describe skin that is dry, irritated and pruritic. Atopic dermatitis, nummular eczema, irritant contact dermatitis, allergic contact dermatitis are all forms of eczema.
  
• Cold, dry air and frequent bathing/water contact predispose.
  
• Winter is a particularly bad time for patients with eczema as cold exposure can precipitate eczema which is aggravated by the dry air produced by heating.
• Asthma, hay fever and allergies are commonly associated.

Scratching

Compared with the scratching that occurs in other skin diseases, the scratching of eczema is more likely to

1. Occur.
2. Be pleasurable.
3. Lead to thickening of the skin in areas scratched.
   

Treatment, Brief Overview

• The key intervention is to apply a medium to high potency prescription topical steroid ointment (e.g. 0.1% triamcinolone or fluocinonide) immediately after the bath or shower and then 12 hours later.
• As the skin improves, the patient should switch over to applying a heavy cream or even an ointment immediately after the shower while the skin is still moist. A dry skin handout is available.
• The patient should do their best not to scratch.

RegionalDerm

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