An Atlas of Atopic Eczema (Encyclopedia of Visual Medicine by Lionel Fry

By Lionel Fry

Atopic eczema is the most typical and chronic dermatological obvious often perform. over the past few years, advances were made within the genetics of atopy as a rule, more recent remedies were brought for topical use, and new thoughts advised within the etiology. hence, a brand new textual content on atopic eczema is either well timed and beneficial. Written through one of many world's so much special dermatologists, An Atlas of Atopic Eczema offers complete assurance of this pores and skin affliction, together with new details on calcineurin inhibitors and their healing strategies. broadly illustrated in colour, the atlas explores themes similar to genetics, etiology, pathogenesis, analysis, medical positive aspects, differential analysis, relationships to different different types of eczema, and remedy. the writer lifts the veil of misunderstanding and is helping physicians remain on most sensible of the problem the elevated prevalence of eczemas current.

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CLINICAL FEATURES OF ECZEMA PER SE Before considering the specific features of atopic eczema, it should be appreciated that there are other clinical patterns of eczema. Many features are common to all these patterns of eczema, depending on the severity of the eczematous process. In mild forms, the skin is red and scaly (Figure 15); in the severe forms (subacute eczema), the skin may be ‘edematous’, due to tissue fluid, and, on the surface, there is crusting. Crusts represent the breaking down of the epidermis, with serum seeping from the surface but coagulating to form a yellow dried surface (Figures 16 and 17).

In addition, individuals who have never had eczema but who have a dry skin often have a family history of atopic disease or a personal history of asthma and hay fever. Dryness is essentially an abnormal shedding of the stratum corneum/keratin layer (the skin barrier). It is thought that the bonding of the corneocytes is impaired, leading to increased loss of keratin. Keratin bonding is temperature-dependent. The lower the temperature, the less the bonding and thus the drier the skin. Atopic subjects often complain that their skin is drier and cracks more easily in the winter months.

Occasionally, the patches are red and raised and urticarial in appearance, and this CLINICAL FEATURES 23 Figure 15 Redness and minimal scaling in mild eczema can subsequently progress to scaling, crusting or weeping, depending on the severity of the inflammation. Although atopic eczema classically involves the flexures of the knees and elbows, in infants the involvement is frequently on the extensor surfaces of the limbs when the disease first presents (Figures 28, 30–32). The scalp may be involved and, in its mildest form, will present as scaling (dandruff).

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