DERMATITIS PROGNOSIS

Dermatitis

Dermatitis, commonly called eczema, is an inflammation of the skin.

Features of dermatitis include:

•	Red, hot skin
•	Swelling
•	Crusting and scaling
•	Itchiness
•	Weeping and oozing of fluid.

There are different types of dermatitis, including:

•	Contact dermatitis

This is due to an allergic reaction that occurs when the skin comes in contact with a particular irritant, e.g. nickel allergy (nickel is commonly found in jewellery) or certain chemicals.

It commonly affects the hands. Household cleaners and hairdressing sprays can also be irritants. Abrasive clothing may worsen dry skin.

•	Seborrhoeic dermatitis

This is due to excess production of sebum from the oil glands, and presents as redness and scaling of the skin. It can start as cradle cap or as a rash around the nappy area in infants.

•	Atopic dermatitis

This is also called infantile/childhood eczema. There is an inherited tendency towards this type of eczema and as such there may be a family history of eczema. It presents as a red, dry, scaly, itchy area on the creases of the elbows, ankles, neck, knees, wrist and scalp.

Children with atopic ezcema tend to be oversensitive to substances such as house dust-mite droppings, pet hairs, or pollen (these are known as allergens). Occasionally, they may have allergies to nuts, eggs and cow's milk.

There may also be a predisposition to hay fever. Atopic eczema generally starts before the age of six months and the child usually grows out of it as they get older.

However, it can sometimes persist into adulthood and indeed can recur in adulthood even after years without symptoms. Atopic eczema may become infected, in which case the skin may weep and exude green/yellow material.

Diagnosis

Dermatitis is usually diagnosed on clinical grounds, based on the patient's history, family history and close examination of the skin. Patch testing is sometimes required in contact dermatitis to determine if a particular irritant causes the dermatitis.

The patches, which contain diluted versions of the suspected allergens suspended in white soft paraffin, are placed on the back. They are taken off after two days. A test is positive when there is an area of eczema underlying the patch.

Prevention - treating the cause

The cause of the dermatitis should be removed where possible. If you have contact dermatitis avoid contact with nickel, perfumed soaps, bubble baths and detergents. Take off rings when washing as soap can gather underneath them. Wear rubber gloves when doing housework.

In the case of atopic eczema, you should vacuum carpets and wash bed linen regularly. Mite-proof encasings on pillows and mattresses can help to eliminate house dust-mite and wooden floors may be more suitable than carpets. Avoid having pets in the house.

Stress and scratching may make the itching worse. Relaxation techniques may be helpful to relieve stress.

Symptom relief

When the skin is dry it becomes itchy. It is important to moisturise the skin with emollients, e.g. aqueous cream or emulsifying ointment applied to damp skin after bathing.

Emollients are available in ointment or cream formulations. Ointments tend to be greasier and as such are useful for very dry skin. The moisturiser should be applied twice a day to the skin and can also be used in the bath.

Medication

Topical steroids (i.e. steroids that are applied directly to the affected skin) may be required. Steroids can be mild (e.g. 1% hydrocortisone) or moderately potent. The mildest possible dosage of steroid should be used to control the dermatitis. These should always be prescribed by a doctor and should be used sparingly.

If there is a superimposed infection, then antibiotic preparations may be necessary. These may be prescribed topically or by mouth if the infection is more severe.

Antihistamine tablets may be prescribed to relieve itching. However, some antihistamines may cause drowsiness.

DERMATITIS RELATED ITEMS

	DERMATITIS DEFINITION
	DERMATITIS DESCRIPTION
	DERMATITIS CAUSES
	DERMATITIS SYMPTOMS
	DERMATITIS DIAGNOSIS
	DERMATITIS TREATMENTS
	DERMATITIS PROGNOSIS
	DERMATITIS INFORMATION
	DERMATITIS PREVENTION