Eczema (dermatitis) is one of the most common skin diseases. It is an inflammatory skin condition that may be caused by a number of factors. Common symptoms of eczema include edema (swelling), redness of the skin, pruritus (itching) and peeling of the skin.
Eczema is not contagious.
Eczema is caused by external factors (external stimuli) or internal factors (heredity, allergies).
Atopic dermatitis (eczema) is a chronic inflammatory skin condition of unknown etiology, believed to have a hereditary component. Hereditary predisposition is observed in 70% of the cases. It affects 5‑15% of school age children and 2‑10% of adults. People with atopic dermatitis often suffer from food allergies, asthma, rhinitis, urticaria, and are more susceptible to infections by staphylococcus and viruses. Although the etiology is not known it has been found that aeroallergens and food allergens play a role. At the nutritional department of our clinic we perform the diagnostic test Asyra that identifies the foods that may be implicated in the exacerbation of atopic dermatitis. By avoiding these food allergens we can improve the skin condition in atopic dermatitis.
It occurs in infants as dry red plaques on the face and the cheeks.
In children and adults it occurs as erythema with pruritus and flaking in body folds e.g., behind the knees and the elbows. There is almost always pruritus and dry skin.
Seborrheic dermatitis often occurs in adults and infants. Malassezia furfur (formerly known as Pityrosporum ovale) is implicated in the etiopathogenesis of the disease. In infants, it presents as reddish yellow scales that form plaques. In adults, it presents in areas rich in sebaceous glands, such as the scalp, with varying degree of exfoliation (it is perceived as dry skin by the patient), while other common sites of localization include the eyebrows, the sides of the nose, the area of the sternum and the back. The rash in these areas presents redness, exfoliation without pruritus. Flare-ups of the disease are observed in winter and during periods of stress. It presents in the form of red exfoliation plaques on the face, the sides of the nose and above the eyebrows. The examination of the scalp often reveals sticky flakes on hair. Sometimes, a rounded plaque is observed in the middle of the sternum. The skin of the face gets easily irritated. The scalp presents pruritus (itching).
The treatment of seborrheic dermatitis is carried out with the application of topical corticosteroids, topical immunomodulators (calcineurin inhibitors) and special shampoos with antifungal activity.
Irritant contact dermatitis
Irritant contact dermatitis causes skin inflammation from a direct reaction to the effect of irritants for a short or longer period of time. Chronic irritant dermatitis is usually caused by more than one factor.
Water, detergents (dermatitis of the housewife), soaps, cleaning agents, antiseptics, building materials, herbal substances such as tomato, onion, oils, acids and many others can cause the condition. In the acute phase, clinical presentation includes pruritus, irritated skin with edema and bullae (blisters). In more severe dermatitis there may be pain and intense inflammation with effusion (liquid). The bullae and the edema subside in the sub-acute phase whereas formation of papules, scubs (crusts) and exfoliation is observed. During the chronic phase, where the irritating agent acts for a long time that exceeds 2 months, thickening of the skin is observed with exacerbation in body folds, dryness, pruritus and hyperpigmentation. This condition is called lichenification.
Allergic contact dermatitis
Allergic contact dermatitis is the inflammation caused following the contact of our skin with certain substances (chemicals or natural substances) with the involvement of immunological mechanisms. It is attributed to hypersensitivity of the skin to irritants. Erythema may occur in the contact area or away from it.
The substances that cause allergic contact dermatitis are very common in every day life and the genetically predisposed individual has many opportunities for sensitization. Among the substances that can cause allergic contact dermatitis are: nickel in jewelry, belt buckles, coins, resins, cosmetic ingredients, cement, pharmaceutical formulations for topical application, plants (e.g., chrysanthemum), etc.
It is treated by:
Topical corticosteroid preparations (creams)
Systemic steroids in severe cases (orally administered or injectable)
Topical immunomodulators (calcineurin inhibitors)
Avoiding contact with the allergen