Domina

Dermatitis, also known as eczema:

It is a chronic inflammatory skin condition characterized by the appearance of red patches or skin rashes. It affects approximately 20% of children and 10% of adults. It can manifest anywhere on the body, from the head to the soles of the feet

Causes:

Dry skin, exposure to irritants, genetic factors

Symptoms:

Itching, often accompanied by pain (the most common symptom)
Severe skin dryness
Skin peeling and inflammation
Red patches or pustules, which can be oozing (these symptoms are more severe)

Types:

Firstly: Atopic Dermatitis:

It is the most common type of eczema, especially in children
It's a chronic condition, treatable but can recur
Intense itching, especially at night, is a prominent symptom
It appears as a skin rash or dry red patches that may bleed when scratched
Those affected are more prone to developing asthma and various allergies, including seasonal allergies

Secondly: Contact Dermatitis

This type of eczema occurs due to environmental triggers
It exhibits the same general symptoms as eczema
It has three subtypes

Irritant Contact Dermatitis:

Represents approximately 80% of all cases
Its main causes include exposure to irritating chemicals
It manifests as an undefined skin rash at the site of direct exposure
There is no immune system involvement in this type

Allergic Contact Dermatitis:

Occurs due to an immune system response to a particular substance
Causes include:
- Products containing preservatives
- Continuous occupational exposure to allergenic substances such as rubber or latex

Photocontact Dermatitis:

Photocontact dermatitis occurs when a person comes into contact with a substance and sunlight simultaneously. These irritants or allergenic substances are usually external, such as certain sunscreen products, or a result of medication ingestion

Thirdly: Neurodermatitis:

Appears in the form of one or two patches on the body
It has a thickened appearance and a rough texture
Can form anywhere, such as the feet, ankles, hands, and wrists
Prominent symptoms include nocturnal itching. The more the itching intensifies, the more scratching occurs, leading to skin irritation, inflammation, and worsening of the condition

Fourthly: Dyshidrotic Eczema:

This type of eczema causes small, itchy blisters on the hands or feet. These blisters may be open and red
Causes include allergies and moisture on the hands and feet

Fifthly: Nummular Eczema:

Nummular eczema can occur at any age
It affects males more than females
It can affect any part of the body except the face and scalp
The causes are not clear, but they may include skin irritants, severe skin dryness, insect bites, scratches, and chemical burns
The patches are coin-shaped on the arms and legs
The skin around the patches is scaly and inflamed

Treatment for the aforementioned types of eczema:

Topical Moisturizers:

Topical moisturizers are a fundamental aspect of skin care
Their use should be continuous, even if the skin appears healthy
It is recommended to use them 2-3 times a day in generous amounts

Examples include:

Panthenol Domina Cream, a suitable moisturizer for all skin types

LinolaDerm Cream, suitable for severely dry skin

Topical Steroids:

They are considered the primary treatment for mild to moderate cases
When used correctly, they are safe and effective
They help reduce inflammation, itching, and swelling
Apply a thin layer to the affected areas
The choice of steroid is based on the severity of the condition and the affected area, as follows:
- Low potency steroids are used on thin-skinned areas, such as the face or neck
- High potency steroids are used on thicker-skinned areas, like the palms, soles of the feet
- Low potency steroids are used for mild cases, while high potency steroids are used for severe cases

To achieve the desired benefit from topical steroids:

Begin by applying topical moisturizers
Wait for approximately 30 minutes
Then apply the topical steroid

Topical Steroids Used in Treating Eczema:

Hydrocortison Domina cream
Motasone cream
Betamethason Domina cream, ointment
Motasone ointment
Domivat cream, ointment

Note: The strength of the steroid ranges from weakest to strongest (Hydrocortison Domina being the weakest, and Domivat being the strongest). Treatment typically starts with Hydrocortisone Domina as it is the safest option, considering the method of application for the steroid

Sixthly: Stasis Dermatitis:

Also known as venous eczema, it's a skin condition that occurs as a result of varicose veins
Its symptoms are similar to the aforementioned types of eczema
It is more common in individuals aged 50 and above
Women are more susceptible to this condition than men

Treatment:

Treatment begins by addressing the cause through the following measures:

Avoiding prolonged standing and wearing compression stockings to reduce swelling and improve blood flow
Keeping the feet elevated above heart level for 15 minutes every two hours and during sleep
Using an appropriate moisturizer to treat dry skin
If there is pain, redness, or swelling, topical steroids are used

Seventhly: Seborrheic Dermatitis:

It is considered a chronic inflammatory form of eczema
It appears in areas rich in sebaceous glands, especially the scalp
It causes various symptoms ranging from dandruff to skin rashes in the affected area
Seborrheic dermatitis occurs due to a combination of genetic and environmental factors
Typically, the trigger is a fungal infection that leads to changes in the skin's nature
Certain medical conditions, such as psoriasis and acne, can increase the risk of individuals developing seborrheic dermatitis
It is not contagious

Treatment:

For cases of scaling, options include:

Salicylic acid
Topical steroids

Note: Betasalic solution contains both betamethasone and salicylic acid

3. For fungal infections, you can use topical antifungals like Kenazole shampoo

In cases of infants with seborrheic dermatitis, often referred to as "cradle cap," which appears as greasy, scaly patches on the scalp, you can wash the baby's scalp daily with warm water and baby shampoo. However, be cautious with anti-dandruff shampoos, as they may irritate the baby's skin. It's advisable to consult a paediatrician for suitable shampoo options. To remove thick patches, apply oil and gently comb the area with a small hairbrush to help remove the scales

Prevention of Eczema in General:

Maintain Skin Moisture and Protect from Dryness: Ensure your skin stays moisturized to prevent dryness
Avoid Sudden Temperature Changes: Sudden temperature changes can trigger eczema flare-ups, so try to maintain a stable environment
Avoid Contact with Allergenic Substances: Stay away from substances that trigger allergies, such as certain cleaning agents and chemicals
Maintain Mental Health and Avoid Stress: Taking care of your mental health, reducing stress, and managing anxiety can positively impact your overall well-being and may help in preventing eczema flare-ups

References:

1. Association NE. What is Eczema? 2023 [Available from: https://nationaleczema.org/eczema/.

2. NHS. Atopic eczema 2022 [Available from: https://www.nhs.uk/conditions/atopic-eczema/causes/.

3. dermnetnz. treatment of atopic dermatitis 2023 [Available from: https://dermnetnz.org/topics/treatment-of-atopicdermatitis.

4. Association TNE. Atopic Dermatitis 2023 [Available from: https://nationaleczema.org/eczema/types-of-eczema/atopic-dermatitis/.

5. Fletcher J. Triggers of contact dermatitis and how to treat it. medical news today. 2023.

6. Association TNE. Contact Dermatitis 2023 [Available from: https://nationaleczema.org/eczema/types-of-eczema/contact-dermatitis/.

7.Brody B. What Is Neurodermatitis? 2022 [Available from: https://www.webmd.com/skin-problems-and-treatments/eczema/neurodermatitis-overview.

8. Watson S. Dyshidrotic Eczema 2022 [Available from: https://www.webmd.com/skin-problems-and-treatments/eczema/dyshidrotic-eczema.

9. Association TNE. Dyshidrotic Eczema 2023 [Available from: https://nationaleczema.org/eczema/types-of-eczema/dyshidrotic-eczema/.

10. Association TNE. Nummular Eczema 2023 [Available from: https://nationaleczema.org/eczema/types-of-eczema/nummular-eczema/.

11. Dermatology TAAo. ECZEMA TYPES: NUMMULAR ECZEMA SELF-CARE 2023 [Available from: https://www.aad.org/public/diseases/eczema/types/nummular-dermatitis/self-care.

12. Guidelines of care for the management of atopic dermatitis. Journal of the American Academy of Dermatology. 2023.

13. Association TNE. Stasis Dermatitis 2023 [Available from: https://nationaleczema.org/eczema/types-of-eczema/stasis-dermatitis/.

14. DiLonardo M. What Is Venous Stasis Dermatitis? 2022 [Available from: https://www.webmd.com/skin-problems-and-treatments/eczema/venous-stasis-dermatitis.

15. Association TNE. Seborrheic Dermatitis 2023 [Available from: https://nationaleczema.org/eczema/types-of-eczema/seborrheic-dermatitis/.

16. DermNet. Seborrhoeic dermatitis 2023 [Available from: https://dermnetnz.org/topics/seborrhoeic-dermatitis.

17. Shaban D. Eczema: Symptoms, Causes, Treatment 2023 [Available from: https://www.webmd.com/skin-problems-and-treatments/eczema/atopic-dermatitis-eczema.