​Dermatology - Atopic Dermatitis ( Eczema)

​Dermatology - Atopic Dermatitis ( Eczema) 
Eczema, also known as atopic dermatitis, typically first appears in infancy and peaks in early childhood with a prevalence of 15-20%. It is common for atopy, allergic rhinitis, or asthma to run in families.
Aeroallergens, including dust mites and pollen, microorganisms, autoallergens, foods—particularly eggs, milk, peanuts, soybeans, fish, and wheat—clothing, particularly wool, and bacteria are examples of triggers.
Stress may be the cause of flares, which are more frequent in the winter and after taking off clothing.
As they say, "eczema is the itch that rashes," pruritus is a must. A vicious cycle of itching, scratching, rash, itching, and scratching results from persistent scratching.
Damage
Scale/edema may be present in poorly defined erythematous patches, papules, and plaques. Scratching may cause moist crusted erosions, which, if they leak, indicate subsequent infection.
Chronic cases result in lichenification/fissures, which can be uncomfortable. People with highly pigmented skin are particularly susceptible to follicular lichenification. Infraorbital fold (Dennie-Morgan sign), periorbital pigmentation, and eyebrow alopecia can all result from rubbing.
The clinical exam and history are used to make the diagnosis. Dermatophytosis, nummular eczema, psoriasis, seborrheic dermatitis, contact dermatitis, and early mycosis fungi are examples of differential. Acrodermatitis enteropathica, glucagonoma syndrome, histidinemia, phenylketonuria, and a few immunologic illnesses are among the other uncommon conditions in the differential.

Teach patients how to apply emollients, refrain from rubbing and itching, and stop secondary infections. Apply topical hydroxyzine for pruritus, topical glucocorticoids, topical antibiotics, and wet dressings as needed. Prescribe unscented emollients, tar, hydroxyquinoline, or glucocorticoids as topical anti-inflammatories, and oil or oatmeal powder baths for subacute and chronic instances. Although they are the most effective, long-term usage of glucocorticoids may have negative effects. In cases of subacute atopic dermatitis and small flare-ups, trimecrolimus and tacrolimus are quite effective. PUVA photochemotherapy, narrow band UV (311 nm) phototherapy, and UVA-UVB phototherapy may also be successful.