Types of eczema, diagnosis, treatment
There are thousands of pages of technical texts about eczema, which can confuse patients with " some kind of eczema ". Here we will try to summarise the basic issues of the skin disorders that we call eczema in layman's terms.
There are several groups of diseases with very similar symptoms but different causes and mechanisms of development. It is often necessary for a doctor to not only take a careful history when making a diagnosis, but to supplement it with tests.
Same symptoms, different causes
The following diseases manifest themselves very similarly. The differences are subtle. Diagnosis is made by laboratory and skin tests.
Atopic eczema usually appears at an early age. The child's parents have either eczema or asthma or bronchitis. It begins in infants with dandruff and scabs on the head, seeding red spots on the face, later appearing mainly in the elbow and knee bends, on the neck and face, even later on the palms. The spots tend to be dry, red, peel off, sometimes bursting or forming boggy areas. They are usually very itchy. It is treated with prescription corticosteroids.
Contact allergic eczema occurs at any time of life. It is most often caused by one, rarely up to five allergens. The body triggers an immune reaction on contact, and eczema can appear not only at the point of entry but anywhere on the body from 30 minutes to 72 hours after contact. The skin is red, inflamed, superficial or subcutaneous pimples and blisters appear, the skin peels, cracks or becomes wet and itchy. It is treated with antihistamines and prescription corticosteroids.
Tinea is a group of fungi that is transmitted from animals. The fungus thrives mainly between the fingers, from there it can spread to the palms. The skin itches, burns, pimples, turns red, peels. The diagnosis is confirmed by scrapings. It is treated with antifungal drugs available over the counter at the pharmacy.
Contact chronic (irritant) eczema is the most common form of eczema, so-called from wear and tear. It affects women much more often than men. It is caused by repeated daily contact with chemicals in the home or workplace. The skin, especially on the palms of the hands, the backs of the hands or in between the fingers, becomes dry and scaly. Surface cracks develop. The skin becomes rough and red and itchy on irritation. The development of the disease is gradual, from dry skin to wetting, crusting and cracking of the skin into blood. If a skin test disproves an allergy, over-the-counter products – moisturisers and barrier creams – are sufficient to treat it.
Diaper dermatitis – enzymes in the stool and acid in the urine irritate the skin. The heat and wetness under the nappy contributes to the growth of bacteria, which attack the irritated skin. The result is an inflamed, red, warm and painful rash. To confirm that it is not an allergy to adhesives, latex or bleach in diapers, it is better to do a skin test. It is treated with diaper rash creams.
Seborrhoea occurs mainly in areas where the skin is rich in sebaceous glands. Mainly on the forehead, in the hair, and on the torso. From the excess sebum, the yeast genus Malassezia furfur multiplies on the skin and causes inflammation. The areas are red but may or may not itch, peeling off yellowish, dandruff-like bits of skin. The skin tends to be extremely oily. Culture is necessary to confirm the diagnosis. Antifungals are mainly used for treatment in the form of ointments and powders.
Scabies is a highly contagious parasitic disease transmitted mostly from animals. The scabies mite burrows into the skin where it lays its eggs. Most often in the interdigital area. The hatched larvae migrate under the skin, especially at night. The skin is very itchy, inflamed, red and wet. The patient rubs his hands to blood. The diagnosis is made by microscopic examination or scraping. It's treated with prescription ointments.
