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Eczema 101

"Eczema can play hide and seek"
By: Risa Caldoza-De Leon MD, FPAPSHPIEczema 101

As a skin care physician, I see patients complaining of eczema on a regular basis, mostly kids. There are 7.3 billion living humans on earth, a quarter of this accounts for children aged under 15. Eczema affects up to 20 percent of children all over the world; one of 10 Filipino children, across socio-economic groups and in both genders, has it. Three of 10 adults may suffer its symptoms too.

According to the International Study of Asthma and Allergies in Childhood (ISAAC), which looked at two million kids in 100 countries, AD numbers in children continue to rise, specifically in the 6-7 age group and in low-income countries, such as South East Asia, including the Philippines. About 90% of patients develop the scourge before age 5.

Eczema, pronounce ec·ze·ma, is a very broad term, and is synonymous with dermatitis and skin asthma. Gleaned from the Greek word ekzein, meaning to boil over or erupt, it can mean a whole host of skin conditions, from dandruff to contact dermatitis. In medical jargon, eczema refers to atopic dermatitis (AD), a chronic inflammatory skin disease. "Atopic" describes an inherited tendency to develop dermatitis, asthma and hay fever. "Dermatitis" means that the skin is red and itchy. You know it simply as a rash.

Aside from the unsightly skin polka dots and relentless itching, eczema can exact a heavy toll. Sufferers can lose up to two-and-a-half hours of sleep a night due to the itch. Kids may have a hard time concentrating in school and have low grades. Its silent impact can have lingering consequences.

Blame it on the genes

Eczema is nothing new. Numerous texts in the Bible talk of “tsaraat,” or skin disease. An Egyptian mummy dating from 892 BC was reported to have dermatosis after modern day scientists examined it. The Egyptian’s Ebers Papyrus contains a section on exfoliative skin diseases. Eczema, sadly, is here to stay.

The skin swells due to internal or external factors. The immune system of a person goes haywire and causes everyday things to make the skin flare up. Eczema can play hide and seek, with periods of exacerbations of flares, and times when the affected skin improves or clears up entirely, called remissions.

Symptoms of AD are patches of red or brown skin that are dry, cracked or scaly. Itching, especially at night is troublesome. Infants usually have tiny bumps on their cheeks, while older children and adults have rashes on the knees or elbows, on the backs of the hands or on the scalp. The more you scratch it, the worse it gets. They develop what is referred to as the “itch-scratch” cycle. A clear fluid may leak from the rash, which eventually will crust and scale.

The truth is, the exact cause of eczema is still unknown. We do know that it is not an infection nor is it contagious. They cannot be transmitted by contact or exposure. The causes of eczema are in the genes. Blame your parents! The triggers include stress and other stuff from the environment, including the weather. Women may have worse symptoms of eczema when their hormone levels change, such as in pregnancy or certain points in their menstrual cycle.

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