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==Differentiating Eczema from other Diseases==
==Differentiating Eczema from other Diseases==
[[Differential diagnoses]] of [[eczema]] include [[infectious disease]], [[inflammatory disease]], [[immunodeficiency problem]], or a [[nutritional deficiency]].
[[Eczema]] has various mimics with regards to the [[clinical presentation]], [[severity]], and [[course of disease]]. A strong [[clinical evaluation]] by the [[physician]] based on the presenting [[signs]] and [[symptoms]] is needed to come up with the correct diagnosis. [[Differential diagnoses]] of [[eczema]] include [[infectious disease]], [[inflammatory disease]], [[immunodeficiency problem]], or a [[nutritional deficiency]].


==Epidemiology and Demographics==
==Epidemiology and Demographics==

Revision as of 15:38, 21 June 2022

Eczema Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Eczema from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Social Impact

Future or Investigational Therapies

Case Studies

Case #1

Eczema On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Eczema

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X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Eczema

CDC on Eczema

Eczema in the news

Blogs on Eczema

Directions to Hospitals Treating Eczema

Risk calculators and risk factors for Eczema

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Edzel Lorraine Co, D.M.D., M.D.

Overview

Eczema is a dermatologic problem manifested as swelling, redness, dryness, and itchiness of the skin. Flaking, cracking, oozing, blistering or bleeding may also occur.

Historical Perspective

It was in the 20th century when eczema came into existence, and later on, concepts on this had evolved including major insights on the nature of the disease.

Classification

Eczema is classified according to location, appearance, or etiology.

Pathophysiology

The mechanism of disease of eczema involves a complex interplay of abnormalities of skin microbiomes, a dysfunction in the epidermal barrier, and an immune dysregulation. There are two main theories on the existence of atopic dermatitis, also known as atopic eczema - the inside-out hypothesis, and the outside-in hypothesis.

Causes

Eczema could be due to a genetic problem, or a result of the adverse effect of certain medication.

Differentiating Eczema from other Diseases

Eczema has various mimics with regards to the clinical presentation, severity, and course of disease. A strong clinical evaluation by the physician based on the presenting signs and symptoms is needed to come up with the correct diagnosis. Differential diagnoses of eczema include infectious disease, inflammatory disease, immunodeficiency problem, or a nutritional deficiency.

Epidemiology and Demographics

In the United States, eczema has a prevalence of 10.7% in children and 7.2% in adults. Eczema has more predilection in males.

Risk Factors

Risk factors of eczema include family history and FLG gene mutation.

Screening

Hanifin and Rajka criteria are the gold standard for diagnosing eczema.

Natural History, Complications, and Prognosis

Eczema has regarded as a medical condition with a natural history that occurs consistently. It is characterized as a disease with an early onset, mostly during the childhood period, and remits during the adolescence period. If left untreated, eczema can lead to viral, bacterial and fungal infections. Psychological problems could also arise brought about by constant itching.

Diagnosis

History and Symptoms

Family history, dietary habits, lifestyle habits, and allergies should be elicited whenever considering eczema as the primary diagnosis.

Physical Examination

Eczema is a [dermatologic disease]] and pruritus is the hallmark feature of this disease.

Laboratory Findings

Levels of IgE are associated with allergy, aside from parasitic infections, autoimmune diseases, and certain carcinomas.

Other Diagnostic Studies

No particular biomarker is reliable to diagnose eczema. However, the current practice is by using the laboratory levels of IgE, which when elevated, can also be associated with allergy, aside from parasitic infections, autoimmune diseases, and certain carcinomas.

Treatment

Medical Therapy

Topical corticosteroids are the mainline treatment for eczema. Different potencies of steroids are rendered specifically for the severity of eczema. Other drug treatments oftenly used for eczema include topical calcineurin inhibitors,crisaborole, antimicrobials, and antifungals.

Surgery

Surgical treatment is not commonly used as a means of management for eczema.

Primary Prevention

Primary prevention is the most effective means to avoid complications of eczema. Emolients and consumption of prebiotics and probiotics can prevent the occurrence of this condition.

Secondary Prevention

Prevention of further trans-epidermal water loss is the cornerstone of management of eczema. Since dysfunctional skin barriers could lead to water loss, daily replenishment of skin moisture is needed. This can be achieved through different modalities such as emollients, occlusives, and humectants.

Cost-Effectiveness of Therapy

The economic impact of eczema causes a burden to patients suffering from this disease. A recent study showed that an average of $274 ($199 indirect cost, and $75 direct cost) is spent by each patient for eczema.

Social Impact

Pruritus and constant scratching of the skin can significantly affect the social life of patient. Sleep disturbances, attention-deficit/hyperactivity disorder, headaches, daytime fatigue, and stunted growth are commonly seen in these patients and could lead to embarrassment and poor self-esteem.

Future or Investigational Therapies

Future trends will focus more on genetic studies in eczema.