An Atlas of Atopic Eczema by Fry L.

By Fry L.

During this concise atlas, Fry (emeritus, Imperial collage) starts off with dialogue of the definition and prevalence of atopic eczema and follows with information regarding stories that reveal a rise in prevalence and a courting among eczema and the chance of constructing bronchial asthma and hay fever. He appears to be like on the function of genetic components and result of dual experiences and genome monitors; the histological gains of acute, subacute and protracted eczema; and etiological elements, together with attainable genetic applicants, allergens and contributory components resembling pollutants and the ''hygiene hypothesis.'' the ultimate chapters comprise well-illustrated descriptions of medical positive factors and differential prognosis, and a extensive dialogue of therapy, which include topical medicinal drugs, organic brokers, and measures which can reduction in administration (e.g. not on time creation of definite meals and alteration of maternal diet).

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36 AN ATLAS OF ATOPIC ECZEMA Figure 31 Extensor surface involvement on the knees in an infant. aureus. Crusting and superficial erosions are present CLINICAL FEATURES Figure 36 Secondarily infected eczema, with weeping surface and satellite papules, vesicles and papules 41 42 AN ATLAS OF ATOPIC ECZEMA Figure 37 Involvement of the popliteal fossae, one of the common sites of atopic eczema Figure 38 Involvement of the ante-cubital fossae, another classical site CLINICAL FEATURES Figure 39 Involvement of the ante-cubital fossae with excoriations, a feature of atopic eczema Figure 40 Symmetrical involvement of the wrists and antecubital fossae in atopic eczema 43 44 AN ATLAS OF ATOPIC ECZEMA Figure 41 Symmetrical involvement of the ankles, popliteal fossae and thighs CLINICAL FEATURES Figure 42 Involvement of the gluteal folds, a common site in atopic eczema Figure 43 Acute atopic eczema in the central cubital fossae with satellite lesions developing 45 46 AN ATLAS OF ATOPIC ECZEMA Figure 44 Extensive confluent atopic eczema on the forearms.

In its more severe forms, the involvement is extensive, although there is sparing of the flexures of the limbs (Figure 82). Both ichthyosis vulgaris and the xeroderma of atopic eczema improve in the warm weather and deteriorate in cold climates. Both conditions are defects in keratin bonding, which is temperature-dependent. INFECTIONS There is an increased incidence and severity of infections associated with certain bacteria, viruses and fungal microorganisms. There are two possible explanations for this observation: first, a defect in the barrier function of the stratum corneum and, second, an altered immune response to certain microorganisms.

Thus, the skin at the sites of the eczema may either become darker (Figures 59 and 60) or paler (Figures 61 and 62). The pigmentary changes often become more apparent CLINICAL FEATURES 25 Figure 17 Subacute eczema with crusts and some erosions Figure 18 Loss of surface of the skin with a weeping surface in acute eczema after the eczema has cleared. Both the hypo- and hyperpigmentation will resolve and the skin return to its normal color, although it may take many months. Hypo- and hyperpigmentary changes are more apparent in dark-skinned and particularly black individuals, as it seems their melanocytes are more susceptible to inflammatory changes.

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