Dermatitis (Eczema) Treatment- Dermatology, Pediatrics

Dermatologists i.e. doctors who have  specialized in the treatment of skin disorders are the doctors who are involved in diagnosing and treating eczema.

What is dermatitis (eczema)?

Dermatitis (eczema; atopic dermatitis) is a chronic condition which makes patient’s skin red and itchy. Even though this condition is common in children; it can occur at any age. It can occur anywhere on the body such as chest, legs, hands etc.

What tests can be done to diagnose dermatitis (eczema)?

The dermatologist can make a diagnosis of dermatitis (eczema) by examining the patient’s skin as well as medical history.

Following tests are done to diagnose dermatitis (eczema):

• Patch test: During this test, dermatologist would put small quantities of alleged irritants or allergens on the patient’s skin to identify the ones causing flares.
• Blood tests: Blood tests are done to measure high levels of eosinophils and IgE antibody. Patients with eczema have high levels of eosinophils and IgE antibody in blood. Measurement of allergen-specific IgE helps to identify specific allergen responsible for eczema.
• Skin biopsy: This test is done to rule out other skin diseases from dermatitis.
• Allergy skin testing: Prick skin tests are done to regular food items or inhalant allergens to indicate any absence or presence of sensitization to specific allergens due to eczema.
• Buccal swabs: By using buccal swabs, cells (DNA) are obtained from inside of the cheek to investigate any mutations in the Filaggrin gene. This gene is one of the causes of eczema.

What are the treatment options?

• Topical corticosteroid cream: It helps to control itching and repairs the damaged skin. It is important to avoid overuse as it would cause side effects such as thinning skin.
• Calcineurin inhibitors: Creams containing calcineurin inhibitors (tacrolimus, pimecrolimus) help to maintain the skin.
• Antibiotic creams: If there is any bacterial infection, creams containing antibiotics are recommended.
• Oral medications: Oral corticosteroids such as prednisone are recommended during severe cases of eczema.
• Dupilumab: It’s an injectable biologic (monoclonal antibody) to treat patients who do not respond to other treatment options.

Other treatment options include various types of therapies such as wet dressings, light therapy, counselling etc.

• Wet dressings:  It is an intensive and effective treatment for severe atopic dermatitis. Affected area are wrapped with topical corticosteroids and wet bandages.
• Light therapy: It is only used when topical treatments do not work properly. It is also known as photo therapy in which the skin is exposed to controlled amounts of natural sunlight. Or artificial ultraviolet A (UVA) or narrow band ultraviolet B (UVB) either alone or with other medicines.
• Counselling: Patients may benefit by consulting a therapist to get psychological help to deal with the embarrassment or frustration regarding their skin condition.

References:

• https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273
• https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/diagnosis-treatment/drc-20353279
• https://www.nationaljewish.org/conditions/eczema-atopic-dermatitis/do-i-have-eczema

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