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What is atopic eczema?
Eczema refers to a red, scaly, itchy, sometimes weeping skin condition. Atopy refers to an allergic condition that tends to run in families and includes problems such as asthma, hay fever, atopic eczema and skin sensitivities. However, anyone can become allergic.
Atopic eczema is common and affects about 5 per cent of the population. It is not contagious. No particular cause has been found.
What are the symptoms?
In mild cases the skin is slightly red, scaly and itchy and covers small areas. In infants it usually starts on the face and scalp; in severe cases it can cover large areas, is very itchy and starts to weep and become crusted. The children may be very irritable and uncomfortable.
What ages are affected?
Eczema usually starts in infants from any age. It tends to improve from 1 to 2 years, but the rash may persist in certain areas, such as the flexures of the elbows and knees, the face and neck, and the fingers and toes. It tends to be coarse, dry and itchy at this stage. Many children have outgrown it by late childhood, most by puberty, but a few have it all their lives.
What are the risks?
It is not a dangerous disease, but infection can occur from scratching, especially if the skin is raw. Contact with herpes simplex (cold sores) can produce nasty reactions. Patients have a tendency to develop asthma and other 'atopies' later.
What things appear to aggravate eczema?
Note: The relationship of diet to eczema is controversial and uncertain. It may be worthwhile avoiding certain suspect foods for a 3 week trial-these include cows milk, fish, eggs, wheat, oranges and peanuts.
What about skin tests and injections?
The value of allergy testing is doubtful, and 'desensitisation' injections may make the eczema worse.
What is the treatment?
Your doctor, who should be consulted if you are concerned, may prescribe antihistamine
medicine for the allergy and sedation, special moisturising creams and lotions,
antibiotics for infection (if present) and milder dilute corticosteroid creams, which can
be very effective.
Copyright 1995: John Murtagh, Professor of