Eczema

About Eczema

Atopic dermatitis, commonly called eczema, is a chronic inflammatory skin condition affecting hundreds of millions of people worldwide. It is among the most common skin diseases in children, affecting up to about 20 percent of children in some countries. The disease involves skin barrier dysfunction filaggrin gene mutations and immune dysregulation Th2 skewing. Symptoms include intensely itchy pruritic, dry, red, inflamed skin, typically in the creases of elbows and knees, neck, and face. Scratching leads to excoriation, infection, and lichenification thickened skin. Atopic dermatitis is part of the atopic triad with asthma and allergic rhinitis. A substantial proportion of children with eczema later develop asthma or allergic rhinitis. Triggers include irritants soaps, detergents, fragrances, allergens dust mites, pet dander, temperature changes, stress, and skin infections Staphylococcus aureus. Regular use of fragrance free emollients is the foundation of management. Topical corticosteroids hydrocortisone, triamcinolone are the mainstay for flares. Topical calcineurin inhibitors tacrolimus, pimecrolimus are steroid sparing agents. Crisaborole Eucrisa is a PDE4 inhibitor. Dupilumab Dupixent, an IL 4 receptor alpha antibody, is highly effective for moderate to severe disease. Upadacitinib Rinvoq and abrocitinib Cibinqo are JAK inhibitors for severe cases. Wet wrap therapy helps severe flares.