Atopic dermatitis (eczema)

ECZEMA CAUSES

The cause of eczema is not completely understood, although hereditary factors appear to play a strong role. Atopic dermatitis is caused by dysfunction in the outermost layer of the skin (the epidermis). The epidermis is the first line of defense between the body and the environment. When the epidermis is intact, it keeps environmental irritants, allergens, and microbes from entering the body.

In children, eczema is rarely linked to food allergies. If a food allergy is suspected, the child should be evaluated by an allergy specialist.

ECZEMA SYMPTOMS

Most people with eczema develop their first symptoms before age five. Intense itching of the skin, patches of redness, small bumps, and skin flaking are common. Scratching can cause additional skin inflammation, which can further worsen the itching. The itchiness may be more noticeable at nighttime.

Features of eczema vary from one individual to another, and can change over time. Although eczema is usually confined to specific areas of the body, it may affect multiple areas in severe cases:

• In infants, there may be red, scaly, and crusted areas on the front of the arms and legs, cheeks, or scalp. The diaper area is not usually affected.
• In children and adults, eczema commonly affects the back of the neck, the elbow creases, and the backs of the knees. Other affected areas may include the face, wrists, and forearms . The skin may become thickened and darkened, or even scarred, from repeated scratching.

  The skin can also become infected as a result of scratching. Signs of infection include painful red bumps that sometimes contain pus; a healthcare provider should be consulted if this occurs.

  Other findings in people with eczema can include:

• Dry, scaly skin
• Plugged hair follicles causing small bumps to develop, usually on the face,

  upper arms, and thighs

• Increased skin creasing on the palms and/or an extra fold of skin under the eye,
• Darkening of the skin around the eyes