Infantile eczema

Alternative names

Eczema (atopic dermatitis); Atopic eczema; Dermatitis - atopic

Definition

Atopic dermatitis, commonly referred to as eczema, is a chronic skin disorder categorized by scaly and itching rashes. People with eczema often have a family history of allergic conditions like asthma, hay fever, or eczema.

Causes, incidence, and risk factors

Eczema is most common in infants, and at least half of those cases clear by age 36 months. In adults, it is generally a chronic or recurring condition.

A hypersensitivity reaction (similar to an allergy) occurs in the skin, causing chronic inflammation. The inflammation causes the skin to become itchy and scaly. Chronic irritation and scratching can cause the skin to thicken and become leathery-textured.

Exposure to environmental irritants can worsen symptoms, as can dryness of the skin, exposure to water, temperature changes, and stress.

Symptoms

• Intense itching
  
• Blisters with oozing and crusting
  
• Skin redness or inflammation around the blisters
  
• Rash
  o In children under 2 years old, skin lesions begin on the cheeks, elbows, or knees
  o In adults, the rash more commonly involves the inside surfaces of the knees and elbows
  
• Dry, leathery skin areas
  o More or less pigment than their normal skin tone (see skin, abnormally dark or light)
  o Located commonly in the inner elbow or behind the knee
  o May spread to the neck, hands, feet, eyelids, or behind the knee
  
• Raw areas of the skin - from scratching
  
• Ear discharges/bleeding
  

Signs and tests
Diagnosis is primarily based on the appearance of the skin and on personal and family history. The health care provider should examine the lesions to rule out other possible causes. A skin lesion biopsy may be performed, but is not always required to make the diagnosis.

Treatment

Consult your health care provider for a diagnosis of eczema because it can be difficult to differentiate from other skin disorders. Treatment should be guided by the health care provider.

Treatment may vary depending on the appearance (stage) of the lesions - acute "weeping" lesions, dry scaly lesions, or chronic dry, thickened lesions are each treated differently.

Anything that aggravates the symptoms should be avoided whenever possible, including any food allergens and irritants such as wool and lanolin.