ECZEMA

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Both laymen and physicians use the word eczema loosely. It is as term that encompasses all kinds of red, blistering, oozing, scaly, brownish, thickened and itching lesions.

Examples of eczema include: (1) allergic contact eczema or dermatitis (common examples are eruptions resulting from an allergy to poison ivy, sumac, oak, & mango; allergy to cosmetics, chemicals, dyes or detergents); (2) seborrheic eczema (appearance of yellow-pinkish-brownish, thickened, greasy skin areas); and (3) nummular eczema (appearance of coin-shaped, oozing, crusting patches). This pamphlet will describe an entirely different type of skin disease that is called atopic eczema or, preferably, "atopic dermatitis."

ATOPY AND ATOPIC ECZEMA OR ATOPIC DERMATITIS

The term "atopy" was coined to describe a strange disease. The term adjective "atopic" designates a group of allergic or associated diseases that often occur in several members of the same family. Many members of these families suffer, not only from allergies such as hay fever and asthma, but also from skin eruptions called atopic dermatitis.

About one patient in five with atopic dermatitis does not have any other discoverable allergic or atopic diseases in himself or his family.

Atopic dermatitis is a very common disease in all parts of the world, and it affects about 3% of the U.S. population.

The disease occurs at any age, but mainly from infancy to young childhood.

The lesions are excruciatingly itchy, and sometimes disfiguring. Because atopic dermatitis attacks children of impressionable age, and adolescents in an insecure period of life, it handicaps and emotionally cripples thousands of young people.

Most patients recover from the condition in early childhood or sometime before the age of 25. Occasionally, however, patients suffer from atopic dermatitis throughout life.

CHARACTERISTIC APPEARANCE AND COURSE

When the disease starts in infancy, it is sometimes called infantile eczema.

This is an itching, oozing, crusting dermatitis that tends to be localized principally on the face and scalp, although spots can appear at other sites.

In his attempts to relieve the intolerable itching, the child rubs his head and cheeks, and other affected areas, with his hands, on his pillow, and on anything he can reach. He cries, and neither he nor his parents can sleep.

Some consolation may be given to these families by telling them that over half of the babies recover from the disease before 2 years of age. Moreover, modern treatment can be most helpful, sometimes bringing almost complete control of the itching until nature's time-cure brings final remission.

If the disease continues or recurs beyond infancy, the skin lesion has less tendency to be red, blistering, oozing, and crusting. Instead, it tends to become dry, brownish-gray, scaly and thickened.

In the adolescent and young adult, the eruption typically occurs on the large folds of the extremities, on the elbow bends and backs of knees, on the face, neck, and upper chest. Although these area among the most common sites, other areas also may be involved.

The thickened skin shows accentuated skin markings and intense, almost unbearable itching continues. Patients scratch at their skin until the lesions are bloody and crusted. The itching is almost always most severe during the night.