Eczema

Eczema also known as atopic dermatitis, is an allergic skin disorder which affects approximately 1% of all children and about 27% of infants born to mothers who themselves have an allergic disease. Ten percent of children who have atopic dermatitis develop symptoms before the age of one year, but fortunately, about one-half of these children become symptom-free by the age of two years. The dermatitis of the other half may not clear until late adolescence, although a small fraction never clear completely. If atopic dermatitis makes its first appearance in a child who is over one year old, the possibility of early clearing is less likely.

Itching, sometimes intense, is the hallmark symptom. With time the lesions tend to scale and flake and, if bacterial or viral infection is introduced by scratching, the affected lesions will ooze. In infants, atopic dermatitis commonly appears on the face and in the creases behind the ears, at the elbows, behind the knees, and at the buttocks. In children, the skin of the outer arms and legs may also be affected. Diagnostic tests which are helpful, when there is no family history of allergies and the child does not have asthma or nasal allergies, include a blood test for the quantity of circulating IgE antibodies, which are elevated in 80% of atopic dermatitis patients, and allergy skin tests. The latter are useful in identifying foods or inhaled substances such as house dust, dust mites, animal dander, or pollen to which the patient is allergic, and which may be responsible for flare-ups of skin lesions. If the patient reacts significantly to foods when skin is tested, these foods should be eliminated from the diet and the effect of their removal should be observed by the patient or the family. If a food or foods are clearly the culprit, they should be removed completely from the diet. If the food is an essential food, such as milk in infants, the allergist will be able to recommend non-allergenic substitutes. If environmental factors are suspected, they should be dealt with similarly.

Itching can be minimized by bathing in tepid water and using unscented soap, patting (not rubbing) the skin to partially dry it, and applying a cream or lotion immediately. Steroid creams or ointments are useful for application to severely affected areas, but should not be applied to the face. Certain antihistamines are very helpful in relieving itching, and in many situations, non-sedating, long-acting antihistamines are especially desirable. To improve the symptoms, fingernails should be kept short and clothing fabrics should be soft and porous when possible. Laundry detergents should be mild and free of perfumes. If there is oozing from the affected skin areas, the patient should consult a physician, since antibiotic treatment may be necessary.

If you have any further questions please contact our hotline:

Ellen Epstein, M.D.
Advanced Allergy and Asthma, PLLC.
Adult and Pediatric Allergy
165 N. Village Ave. - Suite 141
Rockville Centre, NY 11570
 516-678-0056


Dr. Epstein is affiliated with Long Island Jewish Medical Center, South Nassau Communities Hospital and Franklin Hospital Medical Center.

 

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