Overview
- Inflammatory skin condition characterised by dry, pruritic skin with a chronic relapsing course
- M=F, usually presents in childhood
- Aetiology → genetics (polygenic inheritance - predisposition for increased IgE formation and sensitisation = type 1 hypersensitivity), triggers (dust mites, heat, humid climate, stress, skin irritation)
- Risk Factors → allergic rhinitis (hayfever), age <5 years, family history of eczema, PMH/FH of atopy (food allergies, asthma)
Contact Dermatitis ⇒ type of eczema occuring following exposure to a causative agent (hx may say patient has new occupation).
Making Diagnosis
Clinical Features:
- Pruritus → may have excorations (scratch marks)
- Dry Skin
- Sites of Skin Involvement → infants typically show involvement of the cheeks, forehead, scalp and extensor surfaces. Children typically have involvement of the flexures, particularly the wrists, ankles, and antecubital and popliteal fossa.
- Acute Flares → erythema, scaling, vesicles, papules
- Lichenification (thick leathery skin due to constant scratching) and Hyperpigmentation → if chronic
Eczema Herpeticum (Medical Emergency) ⇒ severe infection of the skin by HSV 1 or 2. Commonly seen in children with atopic eczema and presents as a rapidly progressing painful rash. Punched out erosions are typically seen. Potentially life-threatining, hence children should be admitted for IV aciclovir.
Investigations: