Itching All Over

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Diagnostic Hallmarks

Distribution – sides and tips of the digits, palms and soles

History of preceding noninflammatory vesicles (dyshidrosis)

Clinical Presentation

Dyshidrosis is a disease of noninflammatory vesiculatio. Eczematization of dyshidrosis develops under two conditions. The first occurs when itching leads to uncontrolled scratching. This superimposition of the itch-scratch cycle leads to vesicle roof disruption and causes excoriations in surrounding, previously normal skin. Weeping and crusting are present because of the broken epithelium. The second condition occurs when closely set vesicles appear fast enough to form fragile multilocular bullae. These break easily, leading to profuse weeping and crusting. New vesicles develop before reepithelialization has occurred, and the process continues indefinitely even without superimposition of the itch-scratch cycle.

In either set of circumstances, eczematous lesions may spread onto the previously uninvolved dorsal surface of the fingers and hands through the process known as autoeczematization. Moreover, the eczematization obscures the noninflammatory nature of the original underlying vesicles. Because of these two changes, the clinician may miss the correct diagnosis unless information is obtained about the very first lesions noted by the patient.

The diagnosis of dyshidrotic eczema is made on a clinical basis. Biopsy is usually not helpful. The differential diagnoses of hand and foot eczema are considered in greater detail in.

Course and Prognosis

Either the superim position of the itch-scratch cycle or the development of closely set repeated episodes of dyshidrosis converts an intermittently active process into one that is chronically troublesome. New crops of vesicles continue to appear on the skin that is already eczematized; this triggers new bouts of scratching and further skin damage. Moreover, mild irritation from exposure to soap and water, which might have been insufficient to harm normal skin, tends to aggravate the condition further. Essentially, a single disease, dyshidrosis, becomes a multifactorial process with additional elements of atopic dermatitis and irritant contact dermatitis.

Pathogenesis

The development of dyshidrotic eczema occurs in only about 10% of patients with dyshidrosis. In some instances, dyshidrotic eczema is simply an extension in severity of dyshidrosis. New vesicles appear more rapidly than old ones heal. In most instances, however, the eczematous appearance occurs as a result of the superim position of the itch-scratch cycle (atopic dermatitis) directly over the noninflammatory vesiculation of dyshidrosis. Not surprisingly, dyshidrotic eczema (as opposed to dyshidrosis itself) preferentially occurs in those who are genetically atopic.

Therapy

In general, the approach to treatment of dyshidrotic eczema is similar to that for dyshidrosis and atopic dermatitis. Soaks, sedatives, and application of mid- to high-potency topical steroids may clear mild cases of dyshidrotic eczema. Patients with more severe disease will require a “burst” of systemic steroids. PUVA therapy, usually topical rather than systemic can be used effectively in cases resistant to more conventional theory. Because of the importance of psychologic factors in both dyshidrosis and dyshidrotic eczema, it is sometimes necessary to consider counseling, behavior modification, and the use of psychotropic medication.

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Many people are affected by Atopic Dermatitis; this disease is characterized by inflamed skin and itchiness and primarily affects the face, the bend of the elbow, and the back of the knee. In worst cases, the majority of the body can be covered. The word atopic was originally used in conjunction with hay fever and asthma.

Atopic Dermatitis (AD) is typically seen in people who suffer from or have family members who suffer from these allergies and it is not a contagious disease. Chances of children getting Atopic Dermatitis correlate with their parents, meaning that heredity is a major factor in diagnosis, symptoms usually appear in babies as a scaly skin which is dry and itchy. Scratching can open the skin leaving sores. Gender and race do not seem to play roles in the disease.

Eczema and AD

Any inflammation of the skin is covered by the term eczema, the most severe eczema is AD. Usually when people say eczema, they are actually referring to AD. Other forms of eczema include: allergic contact dermatitis, Dishydrotic Eczema, irritant contact dermatitis, nummular eczema, and seborrheic dermatitis. Common symptoms include inflammation (characterized by slight swelling and reddish tint) and itching. Blistering, peeling, and draining fluids can be seen in some forms, especially during severe flare ups.

What is causing my flare ups?

AD usually manifests itself through triggers, which may be environmental irritants, allergens, stress (both physical and emotional), and heat (which induces sweating). Triggers should be avoided to reduce flare-ups.

Irritants are usually man made products and irritate the skin on contact, allergens include: certain proteins found in food, pets, or pollen. Upon exposure to triggers, cells that produce inflammation develop in the skin. Scratching worsens the condition as does rubbing.

Climate seems to play a role as temperatures that are very cold, very hot or change suddenly often cause flare ups. Heat and humidity tend to induce sweating which can trigger flare ups while cold temperatures with less humidity can cause dry skin, which induces itching and cause a flare up. Likewise, raises the temperature of the body, inducing sweating. Showering as soon as you finish exercising and using a good moisturizer will help combat flare ups that normally occur from sweating.

There is also something to be said about the liquid intake rule: drink your eight ounces of water every day. Your body needs the fluid to improve its performance, whether that performance if helping to keep the body hydrated or it is removing toxins. Both functions of fluid intake apply to your eczema, so drinking your eight ounces is even more beneficial to you than to other people.

How do I combat it? Flare ups cannot be completely avoided, but they can be minimized through recognizing and avoiding your triggers, keeping the skin clean and dry, and using plenty of moisturizer will also help. When flare ups do occur, it is important to follow through with doctors care. Typical treatments include:

Topical Treatment, Cortisone creams which are applied to the surface of the inflamed skin are the most prescribed treatment. However, there is a new class of topical treatment: Topical Immunomodulators (TIMs), which are non steroidal. These slow the inflammation but inhibiting the skin’s ability to respond to various triggers.

Phototherapy; Ultraviolet light in the form of lazer or sunlamps are used in conjunction with an ointment applied to the skin before treating with UV rays.

How can I manage eczema?

Although eczema can be debilitating, it does not usually have to be. Through treatment and prevention, you will be able to live a fairly normal life. Some simple steps to use in order to help minimize flare up include:

How can I manage eczema?

Although eczema can be debilitating, it does not usually have to be. Through treatment and prevention, you will be able to live a fairly normal life. Some simple steps to use in order to help minimize flare up include:

Proper Skin Care, regular bathing in warm water, using mild soap, and plenty of moisturizer afterward will help keep irritants and allergens off the skin as well as helping combat dry skin. In addition to morning, night, and after bathing moisturizers should be applied when skin feels dry or itchy throughout the day.

Manage Emotional Stress, First, you must recognize stress when it starts. Then proper management should be used. Enroll in a therapy program with a licensed psychologist, psychiatrist, or therapist, this person will also be able to teach you some relaxation techniques. Support groups are a great tool for stress relief as well.

Do not scratch! One way to avoid this is to keep your hands and mind busy. Studies report that more people scratch during idle time than any other time in their day.

Reduce the allergens and irritants that you come up with as much as possible.

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SKIN PROBLEMS IN CHILDREN

(A) Atopic Dermatitis

Atopic dermatitis is the most common chronic skin condition affecting young children. Onset is most often in the first year of life, with xerosis (dry skin), itching and a patchy erythematous rash which may occur on any part of the skin but is most often found on the face, cubital fossae and popliteal fossae. Children with atopic dermatitis are sensitive to environmental irritants and allergens and are prone to cutaneous infections.

Management of this condition has the following components: encouraging compliance, prevention (environmental modification and control of xerosis), treatment (specific medical management of the dermatitis, control of infection), investigation and management of allergy (not applicable in every case).

(B) Pityriasis Alba

Pityriasis alba is a common condition that presents as poorly defined hypopigmented scaly patches on the face and upper arms. It is most obvious in summer (when the skin is tanned), and in dark-skinned children. It is a mild form of dermatitis in which post-inflammatory hypopigmentation is marked. Symptoms are usually minimal. It is more common in, but not confined to, atopic subjects. It must be differentiated from vitiligo, another skin condition. The latter is not scaly and has a very sharp border.

Avoid contact with skin irritants (eg. soap and shampoo) and use a soap substitute. Apply emollient twice daily, and use hydrocortisone 1% ointment topically, twice daily to settle the irritation and scaling. Use a sunscreen daily to avoid excess tanning of the non-involved skin. Corticosteroid treatment will not restore pigmentation, and prolonged use of an emollient coupled with graduated sun exposure is required.

(C) Juvenile Forefoot Dermatitis

Juvenile forefoot dermatitis is a relatively uncommon condition seen in children. The plantar surface of the anterior part of the ball of the foot and the toes is glazed and fissured. The main complaint is of pain from the fissures (rather than itch, which is the predominant symptom in most cases of dermatitis). Occasionally a similar pattern is seen on the fingertips. The prognosis is good and it usually remits by puberty. Avoiding occlusive or tight footwear will be more comfortable, but in general, modifying footwear does little to change the condition. Topical corticosteroids do not help. Avoid skin irritants (eg. soap and shampoo) and use a soap substitute. Apply urea 10% cream with or without lactic

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Psoriasis: Signs and Symptoms and how can they be treated

Psoriasis is a skin disease that lasts long. 2 to 2.6 percent of the population of the United States are affected with Psoriasis.

There are various types of psoriasis. We have Plaque psoriasis, Nail psoriasis, Scalp psoriasis, Guttate psoriasis, Inverse psoriasis, Pustular psoriasis, Erythrodermic psoriasis and Psoriatic arthritis. And the most common of it is the plaque psoriasis. The symptoms of psoriasis may defer depending on what type a person has but may include one or more of the following:

Red patches of skin, inflamed skin usually covered with silver colored scales is the most common form of plaque psoriasis. These patches may be itchy and painful. The itch may occur anywhere in your body including your genitals. Sometimes these red patches crack and bleed.

Psoriasis may also affect your fingernails and toenails. Discoloration and pitting of the nails can also be one of the symptoms of nail psoriasis. This may causes the nails to loosen and will eventually detach from the nail bed. Nails may crumble in most severe cases of nail psoriasis.

Scalp psoriasis or psoriasis on the scalp may appear red. Itchy areas of the scalp may have silvery colored white scales. Flakes are noticeable in your hair or shoulders, especially after scratching your scalp.

Guttate psoriasis affects people less than 30 years of age. Marked by small water-drop-shaped sores on your trunks, arms, legs and scalp.

Inverse psoriasis is the kind that mainly affects the skin in your armpits, groin, under the breasts, and around the genitals. Inverse psoriasis is common the over-sized people and it is worsened by friction and sweating.

Pustular psoriasis is a rare type of psoriasis that occurs in widespread patches or in smaller areas in your hands, feet or fingertips. Generalized pustular psoriasis may causes fever, chills, severe itching, weight loss and fatigue. This type of psoriasis can be triggered by medications, sunlight, infections, pregnancy, perspiration, emotional stress, or exposure to a certain chemical.

Erythrodermic psoriasis is the least common type of psoriasis. It is usually triggered by severe sunburn.

Psoriatic arthritis causes pitted, discolored nails and swollen painful joints that are similar to of arthritis.

Treatments of Psoriasis

Psoriasis can be treated in various ways. Doctors are treating it in steps according to the severity of the disease. Treating psoriasis

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Some Common Treatments for Dermatitis. The term dermatitis is something that is used for many skin conditions and simply refers to an inflammation of the skin and surrounding tissue. Rashes and eczema are both conditions that would fall under the category of dermatitis. While this condition is not life threatening and not contagious in any way, severe cases can be very uncomfortable or even painful for the sufferer. Some cases clear up on their own while others may require some medical intervention.

What Causes Dermatitis

There are many different causes for the many different conditions that fall under this term, and some are simply genetic. This means that you’re just going to be more prone to rashes or extremely dry skin, or to eczema itself. For others, dermatitis might be caused by irritation to the skin such as from prolonged exposure to chemical and other such harsh solutions, to severe weather especially cold wind, or other such elements. It’s not uncommon for those who work with cleaning solutions or who work outside without proper covering to suffer from dermatitis in one form or another; this includes not just on the hands but around the mouth as well, as cold air and vapors can irritate this sensitive area.

Precautions

If you know that exposure to harsh elements is going to cause dermatitis, then you know immediately part of the solution or cure for this condition. It’s important to keep your hands protected at all times. If you work with cleaning solutions, hair care products, or any type of chemical that is going to irritate your skin, you should always wear rubber gloves. If you need to work outside during the cold weather, wear warm gloves. A scarf over your mouth will prevent dermatitis on your face.

You also need to take care of your skin scrupulously if you are exposed to these chemicals or harsh detergents. Those who work in the medical community and so must be washing their hands constantly typically get some form of dermatitis on their hands. There are many safe lotions that one can use regularly to replace these natural oils on the skin and hands that you are stripping away.

When to See a Doctor

Most cases of dermatitis can be treated at home and simply need time to heal. However, if you notice that any patch of skin has become red and inflamed to the point of breaking or is bleeding, you may want to contact your doctor. And if your dermatitis has not cleared up after several days, your doctor may be able to prescribe a topical ointment that will help speed the healing process.

Common Vitamins and over the counter products can help with dermatitis such as Vitamin A, Vitamin B, Vitamin E, Aloe, Chamomile and Unsaturated fats.

Vitamin A and E taken internally and applied to the affected area have been shown to alleviate the systems of dermatitis.

Dr. R. Patila reported good results with Vitamin B therapy for many types of skin problems and rashes.

Aloe Vera will help rejuvenate and tone skin all over. A naturally cooling gel, the Aloe Vera botanical ingredients work together to stimulate the blood circulation and naturally soften the skin.

Chamomile is used to soothe and re-vitalize the skin.

Unsaturated fats stay liquid at room temperature such as soybean, wheat germ, sunflower and corn oil have show to greatly improve eczema.

Always consult your doctor before using this information.

This Article is nutritional in nature and not to be construed as medical advice.

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