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1. ECZEMA Lecture fife
3. ECZEMA
4. TERMINOLOGY Dermatitis = Dermat + itis
refers to skin means
“inflamed”
(thus, inflamed skin)
Other examples: arthritis, colitis,
encephalitis, etc.
5. CARDINAL FEATURES OF INFLAMMATION (warmth) - increased blood flow
(redness) -dilated blood vessels
(pain)- irritation of nerves in inflamed tissues
6. Classification Can either be acute or chronic in nature.
Acute eczema shows marked inflammation of skin, erythema and papules
.
Chronic eczema shows lichenification (thickening of the skin) from repeated rubbing or scratching, post inflammatory hyper- or hypo pigmentation.
Both types can show excoriations.
There is commonly a secondary infection, usually with Staphylococcus aureus (S. aureus).
7. TYPES OF DERMATITIS( ECZEMA) IT IS PRECIPITATED BY EXTERNALSOURCES OR INTERNAL ONES(ENDOGENOUS
Exogenous: contact DERMATITIS(acute)
Irritant, allergic and infective.
Endogenous, chronic Atopic, A steatiOTIC, neurodematisTIS,and other types
8. IRRITANT CONTACT DERMATITIS Non-immunologic inflammatory reaction of the skin due to an external agent
Varied morphology
Clinical types
Chemical burns
Irritant reactions
Acute irritant contact dermatitis
Chronic irritant contact dermatitis
9. COMMON IRRITANTS Water
Skin cleansers
Industrial cleaning agents
Acids and alkalis
Oils and organic solvents
Oxidizing and reducing agents
Plants
Animal products
Miscellaneous
10. FACTORS INFLUENCING THE DEVELOPMENTOF SKIN IRRITATION
11. THE SUBSTANCE, IF IT PENETRATE TO THE DERMAL AREA WHERE VASCULAR AND LYMPHATIC SUPPLY ARE PRESENT
DEGREE OF IRRITATION DEPEND ON:
1- THE INTRINSIC IRRITATION POTENTIAL
2-CONCENTRATION
3-ABILITY TO REMAIN BOUND TO THE SKIN
12. THE CLIMATE;
MACRO;WHICH REFERS TO ENVIROMENTAL CONDITIONSWHICH WILL AFFECT SKIN TEXTURE
MICRO CLIMATE DEPENDS ON WETHER THE SKIN IS OCCLUDED OR LEFT OPEN TO THE ATMOSPHERE
13. THE HOST;
AGED SKIN IS LESS PRON TO IRRITATION THAN YOUTHFUL SKIN, BECAUS E OF GREATER DIFFICULTY IN DRUG PENETRATION THTOUGH AGED SKIN
14. Allergic contact dermatitis
The term “contact dermatitis” describes an inflammation of the skin caused by contact with external agents. Allergic contact dermatitis is a delayed-type hypersensitivity reaction due to the contact with a chemical to which the individual has previously been sensitized. Possible allergens are found in jewellery, personal care products, topical medications, plants and work-related materials. Usually, the eczematous reaction develops within 24 to 72 hours after contact with the causative chemical in a sensitized individual.
16. Atopic dermatitis A chronic problem causing dry skin, intense itching, and a raised rash, some children outgrow atopic dermatitis, or have milder cases as they age. In severe cases, this non-contagious rash forms clear, fluid-filled blisters. What causes atopic dermatitis isn't clear, but those affected may have a personal history of allergies and asthma and a sensitive immune system. IT OCCURE PRIMARILY DURING CHILDHOOD AND EARLY ADULTHOOD
17. Several treatment options for eczema are available. But primarily, it is most important to diagnose correctly and to identify the underlying etiological factors (e.g. allergens in case of allergic contact dermatitis). Avoidance of the a etiological factors is one important therapeutic approach. Symptomatic treatment includes topical and systemic treatment regimens. The treatment depends on the underlying type of eczema and on its localization.The following general guidelines have proved helpful in eczema patients:
18. Asteatotic eczema: this eczema is characterized by dry and fissured skin and by absence of sebaceous secretions. It occurs mainly during the dry weather and in the aged skin.
Neurodermatitis: this is a chronic form of eczema found more often in women. It is often localized in the nape of the neck, legs,genitoanal region, and forearms.
Emotional stress play a role in this condition.
19. Strategy for treatment of eczema In some forms of eczema the patient is sensitive for a wide variety of agents, and therapeutic entities may aggravate already inflamed skin.
In contact dermatitis, drug therapy is needed for only a short time because withdrawal of allergen or irritant ameliorates the condition
20. TREATMENT OF allergic cotact dermatitis Topical glucocorticoids
Oral antihistamines
Compresses
Topical Emollients
Oral antibiotics
Oral glucocorticoids
21. CHILDHOOD ECZEMA
22. OTC products for eczema 1- protestants; zinc oxide past (lesser)and ointment
2- astringents ;soaking in solution of aluminum acetate reduces the weeping for a large areas. Bathes of local astringents compresses(15-30 ) a few time daily help dry the weeping areas. More potent astringents should be reserved until erythemal inflammation of the acute phase subsides in order not aggravate the condition
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3- cooling agents; to reduce the extent of pruritus. In the acute phases of eczema, soothing lotions applied as wet compresses are helpful.
4- antihistamines ;orally administered for their sedative and antipruritis effects.
5- antiseptics; these are useful in infective dermatitis
24. preccautions calamin lotion and other powered-based preparations that dry weeping through water adsorption should be avoided because of their tendency to crust.
Removal of the crust may cause bleeding and potential infections
25. SUMMARY
26. Thank you