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Presentations of eczema

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Atopic eczema

Atopic eczema (AE) is a common problem that affects 15-20 per cent of children and 2-4 per cent of adults. Its development involves both genetic and environmental factors such as stress, allergens, such as house dust mites, pollen and animal dander or hormonal changes in women, and is often associated with related problems of asthma, hay fever or food allergies.

The first signs of itching and erythematous scaly patches on the cheeks usually appear in the first two years of life, with further similar, poorly demarcated patches occurring on other parts of the body. The nappy area is usually spared.

The condition follows a course of exacerbations and remissions, but tends to improve by the time the teens are reached. However some may relapse at a later date. The criteria for the diagnosis of AE are itching, early age of onset before two years, eczematous type skin rashes, history of exacerbations and remissions and family or personal history of other atopic problems. Laboratory testing is rarely of help.

Atopic eczema in pre-school children

Signs may again change in school age children; the pattern of eczema is more likely to affect flexures of the antecubital and popliteal fossae and other areas such as eyelids, ear lobes, neck and scalp are more often involved. In some cases, there may be small disc like areas (nummular eczema) that may give suspicions of ringworm.

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