This book describes Chronic Eczema, Diagnosis and Treatment and Related DiseasesRecently I have a few patients referred to me for chronic eczema (some for ten years) by other patients treated by me.The first thing I do is to exclude serious illness such as psoriasis and diabetes or kidney disease.The second thing is to find out whether there are new foods, soaps or chemicals introduced in the environment before the skin developed chronic eczema.One of the most important is the use of soap and detergents.I generally advised the patient to wash without soap daily or more frequently with plain water for at least 2 weeks before trying soap.Scratching leads to redness, swelling, cracking, “weeping” clear fluid, crusting, and scaling and severe itching.The patient should keep the fingernails cut short and wear light gloves during sleep to prevent scratchingThe patient should avoid scratching the skin but to apply the anti-itch cream on the itchy areas instead frequently.Non-drowsy antihistamines are given during the day and more drowsy antihistamine given at night.Antibiotics are given if there is infection.Mild steroids are given for a short period of time on a tapering course.As for diet the most important is to drink at least 6-8 glasses of water to flush the toxins out of the body.The patient should avoid colored drinks, canned, bottled and packet drinks which contain preservatives.Food like seafood such as prawns, crabs, cockle shells, lobsters and ducks should be avoided because they may contain contaminants from the water and the sea.Tomato ketchups and chilly sauce may contain dyes that can cause skin irritation.Instead the patient should take the fresh chilly or tomatoes instead.Alcohol drinking and smoking should be avoided.Dust, cement and renovations works should be avoided as well.Some perfumes and cosmetics, wool or synthetic fibers should also be avoided.Previous treatments for skin-related symptoms should not be used since they appeared not to work.The patient must learn to relax and get enough sleep.If there are animal pets in the house the patient should also avoid them.Chronic eczema is a long term skin disease.When a person has this disorder the skin becomes excessively itchy.Scratching causes redness, swelling, cracking, weeping clear fluid, crusting, and scalingOften, the skin flares (gets worse) and then it becomes better or clears up (remissions).Chronic eczema is a long-term (chronic) skin disorder that causes scaly and itchy rashesCausesChronic eczema is due to a skin reaction in the skin.The reaction leads to ongoing itching, swelling and redness.People with chronic eczema may be more sensitive because their skin lacks certain proteins that maintain the skin’s barrier to water.1.Allergies to pollen, mold, dust mites, or animals2.Cold and dry air in the winterI had a fellow traveler in New Zealand who developed rashes in the cold temperature of New Zealand. This is due the effects of cold antigens present in some people.3.Colds4.Contact with irritants and chemicals5.Contact with rough materials, such as wool6.Dry skin7.Emotional stressSymptoms:1.Blisters with oozing and crusting2.Dry skin3.Raw areas of the skin from scratchingDiagnosis:Family history of allergies,hay fever or asthmaSkin ExaminationSkin testsTreatment:The goals in treating chronic eczema are to heal the skin and prevent flaresThe most important treatment is Not Scratch the skinKeep fingernailsWear gloves at nightUse a moisturizerTopical steroidBarrier repair creamsAntihistaminesAntibioticsImmunosuppressantTargeted biologic therapyPhototherapyDesensitization using allergen detected in skin testsTABLE OF CONTENTIntroductionChapter 1 Chronic EczemaChapter 2 CausesChapter 3 SymptomsChapter 4 DiagnosisChapter 5 TreatmentChapter 6 PrognosisChapter 7 AllergiesChapter 8 UrticariaEpilogue
