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ITCHING TO KNOW MORE ABOUT ECZEMA AND ECTODERMAL DYSPLASIA

Eczema, sometimes called dermatitis, is inflammation of the skin that can lead to an itchy . There are many different types of eczema, but the most common kind of eczema is . When people refer to eczema, they are typically referring to atopic dermatitis. This condition affects up to 20% of people worldwide, particularly infants and children. Individuals with ectodermal dysplasia, especially hypohidrotic ectodermal dysplasia (HED), are affected even more commonly than the general population with up to 50% having atopic dermatitis.

The exact cause of atopic seasonal , or and on the neck and face. dermatitis is unknown. But, eczema. As the rash becomes more there are many factors that established, the dry skin may make a person prone to this Rarely, atopic dermatitis may be become thickened, leathery, and type of rash. We know the related to food sensitivity, but sometimes darker in coloration main issue in eczema is that this is actually quite rare as food due to repetitive rubbing and the skin barrier that holds in allergies typically cause scratching. moisture and protects us is not and not eczema. In the majority functioning optimally. This is of cases, no allergic triggers When the rash improves, the case even in those without can be found. Therefore, the skin may appear lighter ectodermal dysplasia, but the testing in most cases is not for some time, especially in poorly developed sweat and necessary or helpful in treating a the summer months but this oil glands likely affect the skin person’s eczema. improves on its own with time. barrier even more so in those Most children with atopic with ectodermal dysplasia. When Does Eczema Start? dermatitis improve or “outgrow” Atopic dermatitis usually starts the condition before school -Scratch Cycle in infancy from the ages of two age, but some continue to have The immune system is also to six months. The skin is dry problems as an adolescent or overly active in the skin leading and the rash is quite itchy, so even as an adult. Worsening to inflammation that causes infants may be restless and rub with age is rare, and generally redness and swelling, which against the sheets, or scratch if the condition’s severity can lead to oozing and crusting able. The rash may involve the improves with time. when severe. This inflammation face or it may cover a large part leads to itchiness causing of the body. As the child gets Triggers scratching that further damages older, the rash may affect only a Many things may affect the the skin barrier, making the skin few areas of the body. In early severity of the condition. All prone to even more irritation childhood, the rash is commonly people with atopic dermatitis and infections. We refer to this on the hands, arms, legs and have sensitive and dry as the itch-scratch cycle, and it feet. is often frustrating and stressful for all involved, especially the As a child becomes older, the parents of affected children. rash may be limited to the In many people with eczema, bends of the elbows, knees, there is a family history of wrists, hands, ankles, feet,

T 618-566-2020 E [email protected] W WWW.NFED.ORG skin. Everyone with eczema also tends to spread rapidly in anti-inflammatory experiences flare-ups, and most patients with atopic dermatitis. ointments or creams times specific triggers cannot Treatment may also be suggested, be identified since there are so and are very important many factors that contribute Unfortunately, there is nothing in decreasing the itching and controlling the to eczema. Many will find that that will cure atopic dermatitis, inflammation of eczema. during the winter months when but fortunately with good the humidity is very low, the skin care and treatment the - Your doctor will suggest dryness and itchiness will be condition typically improves. a treatment that is most worse. The main objectives in treating appropriate for the atopic dermatitis is to limit flare- severity and location of the dermatitis that is to On the other hand, some people ups and when they occur, to be treated. are easily irritated by heat and treat them safely and effectively sweat so will find that they so the affected person improves - When the area is clear, it have more problems during the quickly and is as comfortable is best to discontinue the summer months. Most people as possible. It is recommended use of the medications, note an increase in itching at that those with atopic but continue liberal use times when there are sudden dermatitis be evaluated by a of emollients to help prevent reoccurrence. changes in temperature. Flare- board-certified dermatologist, ups will also occur when the if possible, so you can develop - If itching or the rash child has a fever or other illness. a treatment plan that works for reoccurs, the medicated Irritants easily affect the skin of you. ointments or creams may a person with atopic dermatitis. have to be reintroduced. Use of harsh soaps and lack Good skin care using products Certain medicines take by of moisturizing are common that limit further irritation is mouth, called “”, problems. the most important aspect of may help to control the itchiness treating atopic dermatitis. of eczema. The medications

Secondary Infection primarily help with scratching - This includes short, daily Eczema skin can more easily by introducing some drowsiness become infected by bacteria, bathes or showers for less than 15 minutes with and allowing the child to sleep yeast, or viruses. This is called a mild cleanser every at night. “secondary infection.” Bacterial day to decrease any secondary infection with contaminants on the skin Scratching over time becomes Staph is the most common, that may cause irritation a habit for most infants and and often occurs as the result or infection. children with atopic dermatitis of scratching. The rash gets Application of a thick and many children scratch more very red with pus filled pimples - moisturizer immediately when they are tired, upset or and scabs. If this occurs, following bathing is irritated as a learned behavior your doctor may prescribe vital as it helps lock in or coping mechanism. It is an antibiotic to control the moisture since the skin important to break the itch- infection. Dilute bleach bathes barrier in eczema is not scratch cycle that develops, (1 tsp/ gallon) two times per able to do so. and sometimes the help of week can also help prevent There are a number a psychologist is needed for or limit recurrent bacterial - of different forms of older children, so they can gain infections. medication that are used control of their eczema. for atopic dermatitis, and Virus Complications prescription medications A more serious complication that are best suited to can be caused by certain control the problem will viruses. The “cold sore” virus be chosen. Primarily “topical medications” () may cause a (medications that are severe rash with water-filled applied to the skin) will and scabbing. If this is be used. suspected, immediately contact your doctor. The virus that - Cortisone-derived causes molluscum and ointments and newer

NATIONAL FOUNDATION FOR ECTODERMAL DYSPLASIAS T 618-566-2020 E [email protected] W WWW.NFED.ORG The National Eczema Important Tips For Controlling Your Eczema: Association is another wonderful organization that 1. Avoid contact with substances you know cause itching or can provide you with additional flare-ups. These may include wet wipes, soaps, detergents, information and resources perfumes, dust, grass, weeds, wools, and other types related to eczema. It sends of scratchy clothing. In the winter, for example, cotton out a quarterly newsletter that underwear or a cotton shirt may be worn under a sweater. Do offers good information. not use fabric softeners. 2. You should bathe or shower for no more than 15 minutes daily National Eczema Association for but keep the temperature comfortable, but not hot as this Science and Education removes natural oils from your skin. Use a minimal amount of 4460 Redwood Highway cleanser and avoid bubble baths or perfumed soaps. After Suite 16D bathing, pat the skin dry as rubbing can cause more irritation. San Rafael, California 94903- Always apply your moisturizer all over the skin, not just in the 1953 affected areas, within 5 minutes after bathing to help lock in 800-818-7546 or the moisture and prevent further drying that can occur with evaporation. 415-499-3474 www.nationaleczema.org 3. Use skin care products that have the least amount of ingredients, as may soaps, shampoos and moisturizers- even those marketed for eczema- have many potential irritants. While many organic products have the potential to help, they also have the potential to cause even more irritation. People with atopic dermatitis have an increased risk of developing allergies from topically applied products, known as allergic . A common cause of this is neomycin found in Neosporin; therefore, this should be avoided. 4. Try to keep the temperature and humidity in the home fairly constant. People with eczema typically do better in a cool environment. Use a bedroom air conditioner in the summer and a humidifier in winter. It is very important that the humidifier be cleaned well and frequently, since mold may grow and cause worsening of allergy symptoms. 5. Try to avoid scratching. Atopic dermatitis is often called “the itch that ” and it is known that scratching plays a very important role in making the dermatitis worse. Keeping the nails short and well-filed is helpful. Apply cool compresses or cold packs to the area can also help reduce the itchiness.

- Alanna F. Bree, M.D. A Children’s House for Pediatric Houston, Texas

The content of this document is for informational purposes only. Questions regarding specific patient issues should be directed to the appropriate professionals for resolution.

NATIONAL FOUNDATION FOR ECTODERMAL DYSPLASIAS T 618-566-2020 E [email protected] W WWW.NFED.ORG