Who gets eczema?
Eczema, also known as atopic dermatitis (AD), has a prevalence in children of 15% to 20% in industrialized countries. The prevalence of AD in adults is estimated between 3% to 7% worldwide. It is estimated that about 10% adults in Singapore suffer from atopic dermatitis.
What causes eczema?
Eczema is primarily a disease of the immune system.In simple language,eczema is multifactorial, for example, genetic, and environmental reasons, may trigger our own cells mistakenly attack our own skin, cause skin barrier defect.
What is atopy?
Atopy refers to the tendency to asthma, eczema and allergic rhinitis. Atopy is mostly inherited. It is characterised by an overactive immune response to environmental factors. The same factors have no effect on the skin of a non-atopic. Yet, despite their genetic background, some children from an atopic family never develop atopic dermatitis and some children with no family history can suffer from it.
Factors that aggravate eczema:
- Bacterial, fungal or virus infections
- Injuries such as cuts, abrasions, sunburn
- Sun overexposure
- Obesity
- Pollution
- Chemical irritants
- Alcohol
- Hot bath
- Hot and humid weather
- Emotional stress
- Stay late night
- Medications such as lithium, beta blockers, antimalarials, nonsteroidal anti-inflammatory drug
- Stopping oral steroids or strong topical corticosteroids.
How is eczema diagnosed?
Eczema is diagnosed by its clinical features and medical history. If necessary, diagnosis is supported by typical skin biopsy findings.
Current Western Conventional Treatment for Eczema:
Topical Application
- Emollients
- Topical corticosteroids
- Immunosuppressants (tacrolimus, pimecrolimus, crisabarole)
Phototherapy
- Narrowband UVB
- Broadband UVB
- Photochemotherapy (PUVA)
Systemic Immunosuppressant
- Methotrexate
- Ciclosporin
- Mycophenolate mofetil
- Azathioprine
- Systemic corticosteroids
Biologics Immunosuppressant
- Dupilumab (interleukin-4 receptor alpha antagonist)
- Omalizumab (anti-IgE monoclonal anti-body)
Reference
- Christopher Griffiths, Jonathan Barker, Tanya Bleiker, Robert Chalmers & Daniel Creamer. eds (2016). Rook’s Textbook of Dermatology (9th Ed.) London. Wiley-Blackwell
- Jean Bolognia Julie Schaffer Lorenzo Cerroni. eds (2017). Dermatology: 2-Volume Set. (4th Ed.) Elsevier.
