Eczema is a chronic inflammation of the skin.   It occurs as a reaction to various substances, particularly used over the body.

It manifests as flat dry patches, or red coloured rashes, or multiple small vesicular eruptions with oozing of serous fluid which is known as "weeping eczema”. There may be associated crusting over these lesions. One may have a single type of lesion or multiple lesions at the same time.

Atopic dermatitis is a kind of eczema   associated with bronchial asthma. Underlying cause for both the conditions remains the same, that is, allergy to some exogenous substance. This type of eczema is usually generalised.  There   may be dry scaly patches with flaking or vesicular eruptions with oozing and intense itching. Similar to asthma, this type of eczema is also intermittent. It occurs with rains or change of climate or exposure to potential allergens, that is, allergy producing substances.

Allergic contact dermatitis is a type of delayed allergic reaction to the body after the skin is exposed to some substance to which it is sensitive. This type of reaction   commonly occurs due to artificial jewellery, cosmetics with chemical base, contact with allergy producing plants   like poison ivy.  This type of eczema is localised to the site affected on the body. Intense itching   occurs with formation of rashes, scaling or small eruptions. 

Any potentially toxic or irritant substance can cause direct injury to the skin and subsequent eczema, when exposed chronically.   There is cracking, redness, scaling, along with itching on affected part. Common example is cracking of hands and fingers of people who wash   daily, due to direct irritation by the washing soap.

Seborrheic dermatitis is characterised by greyish yellow scales and red patches. It commonly occurs over scalp, eyebrows, behind the ears, near crease of the nose, under arms, and etcetera. What exactly causes eczema, why some people suffer, while some have no problem with exposure to the same kind of substances, is not known. Some breach of the defence of the skin and or some derangement in immune response is the hypothesis postulated.

Anybody suffering from eczema knows how the severe itching becomes   troublesome and embarrassing. Apart from the discomfort, the visible skin problem gives a wrong impression to others, that this, the person has a "dirty skin disease”. 

Scratching caused by the chronic itching leads to secondary bacterial infections and multiple boils. Though out of ignorance people fear it, eczema is never contagious. It can occur in any age or gender, including babies. Rather, babies are more susceptible to it due to hypersensitivity to the baby soaps, creams and powders applied by mothers to keep the infant clean and fragrant.

Eczema is diagnosed by the recurrent nature of the problem, typical skin changes and the site. Atopic eczema is mostly generalised whereas other types of eczema are localised to the site of exposure.

Treatment includes drugs or local ointments which help reduce the itching and ungainly skin eruptions or rashes. But relapses invariably occur. Those suffering from eczema should take precautions to avoid it.

Persons suffering from eczema should avoid the potential allergens like exposure to dust, allergy producing foods, or substances which provoke it. In other types of eczematous dermatitis, a person can know with experience what is causing the problem and avoid it. Mostly, it is the chemical based toiletries and cosmetics which lead to eczema. Instead of using cosmetics with chemicals, one should try using natural herbal products. There is minimal chance of reaction with natural products.  Synthetic clothing made of nylon or polyester should be avoided. Someone with eczema should use only pure cotton or natural silk material for clothes.

Dr Rachna Pande,  Specialist, internal medicine

rachna212002@yahoo.co.uk