Eczema is an inflammatory reaction with redness, heat and itching of the skin that also presents with blisters or vesicles that can ooze. These vesicles can form scabs and scales. Eczema is usually of allergic or microbial origin. If it occurs in just a few days, the eczema is acute; But if it lasts over time, skin that turns red, shines and peels, losing the different skin layers, it is subacute. This form can become chronic and become thickened and dry skin (lichenification).
Causes of eczema
Hereditary and environmental factors
Hereditary factors and environmental causes have been indicated as possible reasons for the appearance of any of the types of eczema:
– Irritant contact eczema: Caused by the effect of an irritating product that comes into contact with the skin for a period of time and with the concentration necessary to produce a reaction. Acids and solvents used in industry or in household cleaning products can generate this reaction by dissolving and eliminating the fatty acid mantle that protects the skin.
– Allergic contact eczema: Skin reaction caused by an allergen (nickel, cobalt, chromium, paraphenylenediamine, mercury, rubber, formaldehyde, topical medications and/or cosmetics). It can appear on any part of the skin but the most common areas are the face, scalp, hands, feet, scalp, trunk, genitals or thighs.
Professional eczema.
Rubber glove eczema.
Eczema due to topical medication.
Eczema due to cosmetics.
Eczema due to objects of use or decoration.
Shoe eczema.
Eczema due to plants.
– Atopic dermatitis: hereditary predisposition.
– Other ways:
Nummular eczema: Coin-shaped spots. Unknown cause. Possible hereditary factors of allergy, asthma or atopic dermatitis. Very chronic evolution and difficult treatment.
Dyshidrotic eczema, dyshidrosis or ponfolix: recurrent outbreaks of hard, very itchy vesicles. They can grow, forming blisters that turn into papules in later stages. Peeling, lichenification, painful fissures and erosions.
Varicose eczema: chronic. It appears in patients with chronic venous insufficiency in the lower extremities.
Photoinduced eczema: Inflammatory reaction triggered by ultraviolet radiation on substances deposited in the skin such as tetracyclines, thiazides, furosemide, among others. It can also be caused by photosensitizing drugs such as antibiotics, antidepressants or non-steroidal anti-inflammatory drugs.
Eczema symptoms
Itching and vesicles
Depending on the type of eczema and its phase of evolution, the morphology of the lesions, vesicles, can range from redness and swelling to vesiculation with exudation and scabs to lichenification with thickening of the skin. The common symptom present from the beginning of eczema is itching, pruritus, which can be light or very intense. Scratching injuries are also a sign.
Diagnosis of eczema
Clinical examination and skin tests
The clinical examination and the description of symptoms are basic in medical diagnosis, both at the level of family medicine and allergy. A blood test may also be requested. The allergist will perform epicutaneous contact tests in cases of suspected irritative or contact eczema.
Eczema treatment and medication
Corticosteroids and antihistamines
The first treatment guideline is to avoid the cause of eczema. If it cannot be avoided or you cannot put a protective barrier in front of it. At a pharmacological level, topical and systemic corticosteroids can be prescribed; antihistamines; antibiotics if there is bacterial infection; and moisturizing creams.
Eczema prevention
Take care of the skin
Preventing the appearance of eczema, especially if it is irritative or contact, involves, first of all, avoiding the cause or potentially irritating substances. It is also recommended to wear cotton clothing, avoiding synthetic materials, use protective gloves when there may be a risk of contact, use mild soaps and perfumes, use warm or cold water for showering or bathing, and avoid activities that involve exposure to sweat.
If we manage to get the eczema to subside and the skin to have a healthy appearance again, we must not stop maintaining care; especially those for topical use unless indicated by the specialist.
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