Eczema Patients

The Persistence of Atopic Dermatitis and Filaggrin (FLG) Mutations in a US Longitudinal Cohort

Since the beginning of this century several studies have been published that have helped to revolutionize our understanding of the pathophysiology of AD. These studies have shown an association between genetic variation and AD.  Genes that have been implicated include genes that code proteins associated with skin barrier and genes that code proteins involved in immune function.

How often should I be applying topical steroids?

Q:  How often should I be applying topical steroids?

A:  Topical corticosteroids are a mainstay of eczema therapy. Sadly, results are often suboptimal because of steroid phobia and mistakes in applying the steroids. The drugs are safe if we focus on two crucial factors: Frequency and Duration.

Here are some suggestions for proper use of topical corticosteroids:
* Apply to hydrated skin (after bath, shower or wet compresses).
* Generally speaking, and based on your doctor’s directions, begin with twice daily applications for durations of NO more than 3 days for face, eyelids, neck and folds 7 to

What do I need to know to use topical steroids correctly?

Q:  Sometimes I don’t follow my doctor’s directions concerning my eczema and steroid medications. What do I need to know to use topical steroids correctly?

A:  Managing eczema is confusing; details are important. Doctors complain that patients don’t follow advice. Probably just as often, patients don’t understand what was advised. It’s best to plan a follow-up visit one to two weeks after a steroid is prescribed to clarify instructions and enhance control of eczema if possible. Ask questions and demand clear answers.

Here are some common mistakes to be aware of in topical steroid therapy:
* Not

My doctor prescribed topical steroids for my eczema, but I am concerned about using them?

Q:  My doctor prescribed topical steroids for my eczema, but I am concerned about using them. Any suggestions?

A:  Topical corticosteroids are often the only reasonable therapy for controlling eczema. They are very effective and, if used properly, very safe. A major reason for failure is when there is an inappropriate prescription of low-potency steroids and the starting and stopping of regimens that never really control and stabilize the inflammation.

Hand Eczema

Q:  Aside from dry skin all over my body. The main place I get eczema is on my hands. When I have a flare up it seems to start with small (1-2 centimeter), clear-fluid, blister-type bubbles on my hands. The bubbles pop, the skin underneath is exposed, and the eczema starts. It takes about 7 to 10 days to heal—sometimes more, sometimes less. This depends on how much care I give it. That clear fluid blister that formed comes from something inside my body. Can you help me understand this? What is that clear fluid? I think it may be histamine. What causes it to come out on my hands?

What causes a person to get eczema on his or her body?

Q:   What causes a person to get eczema on his or her body? How can the terrible itch be helped? Are they working on a cure for this awful stuff?

A:   Atopic dermatitis is the most common type of eczema and has a genetic basis. Recently discovered genetic defects in the skin barrier seem to account for many, if not most, cases. The defective barrier allows chemical and physical irritants and bacterial toxins to trigger inflammation that causes redness and itching.

Allergens that people are not aware of

Q:   What might be some surprising allergens that people are not aware of?

A:   Medications applied to skin that is already inflamed are frequent causes of contact allergy. Examples include hydrocortisone, neomycin, bee glue, vitamin E, and lanolin.

What is the Contact Allergen Replacement Database (CARD)?

Q:   What is the Contact Allergen Replacement Database (CARD)? And can I gain access to it without a physician?

A:   CARD and CAMP (Contact Allergen Management Program) are databases that can suggest personal care products free of specified allergens.
It is impossible for patients or physicians to accurately diagnosis allergic contact dermatitis to the specific components of items that touch the skin without patch testing. Therefore, access to these databases is restricted to patients who have undergone patch testing by a dermatologist.

What is the best information I can provide my doctor with?

Q:  What is the best information I can provide my doctor when I have my appointment?

A:  Describe environmental factors (season, skin care products, antibiotics, etc.) that make your eczema better or worse.

What is the wet-dry cycle?

Q:  What is the wet-dry cycle, and why is it bad for eczema?

A:  The wet-dry cycle refers to the drying of skin dampened with water or perspiration. Imagine a muddy field: if the sun dries the field quickly, the mud cracks; if it dries slowly on a cloudy day the mud stays smooth. Skin with eczema is especially likely to crack in low humidity conditions when it dries quickly. Applying a moisturizer to slow the drying of wet skin is therefore especially important in the winter when the humidity is lower.

What are allergens?

Q:  What are allergens, and what are the most common allergens that aggravate eczema?


A:  Allergens are any molecule in the environment that can penetrate skin and cause an inflammatory response. Most allergens cause a rash in only a small number of people, but some like poison ivy cause a rash in most people who have skin contact with it. Allergic contact dermatitis usually develops to small, non-protein molecules such as preservatives or metals. Atopic dermatitis patients can also develop contact dermatitis to plant proteins such as oat or dandelion.

What is the difference between atopic dermatitis and contact dermatitis?

Q:  What is the difference between atopic dermatitis and contact dermatitis?

A:  Atopic dermatitis appears early in life as chapped skin in areas that go through frequent wet-dry cycles (for example, the area around the mouth in babies) or in skin folds. Atopic dermatitis patients are susceptible to skin infections, which often make inflammation worse. Protein molecules, such as foods, or pollen or latex can penetrate broken and inflamed skin, and atopic patients are especially likely to develop an immune response to these types of allergens.

Allergic to Chloramine

Dear NEA Scratch Pad:

Several years ago, I was diagnosed with atopic dermatitis. The photo shows the rashes on my back, and there were similar rashes on most of the rest of my body. Fortunately I discovered that the problem was chloramine, a mixture of ammonia and chlorine that is used to disinfect the tap water in many areas of the United States (including the San Francisco Bay area, where I live). After I stopped using our water, my skin cleared up completely. I’m sure there are folks with similar problems who are not aware of this chemical and are suffering as a result.

Beeswax and Olive or Almond Oil

Dear NEA Scratch Pad:

I understand that petroleum is used for eczema-prone skin. However, I don't like to use petroleum. I've tried different balms from spas, and found that I could make my own, using beeswax and oil (olive or almond oil). My latest balm is what I call a Bumble Bee Balm. I've only used it on my own skin, and it works for me. I hope you find it useful, too. I realize this will not be an option for people with certain allergies. I purchased the bee products from Rainbow Groceries in San Francisco.

1/4 ounce beeswax
1 cup oil (olive or almond)
manuka honey
royal jelly
propolis
bee

A 3-Year-Old's Story


Dear NEA Scratch Pad:

I’d like to share my wish with the Scratch Pad readers.

A Mother’s Wish: Every morning, I try to start the day positively for my daughter’s sake regardless of how much sleep we didn’t get the night before. Today was no exception. I woke her up at 8:25, only three short hours after she finally fell asleep, after the usual night-long restless tossing and turning, scratching, crying, and scratching some more. We were already running late for her big day.

Today, I took my 3-year-old daughter to her first day of preschool, telling myself “she needs this, she will have fun.” My

New Research Fuels Greater Understanding of Atopic Dermatitis and Psoriasis in Children and Adolescents

BOSTON (Aug. 16, 2012)  Information presented at American Academy of Dermatology’s Summer Academy Meeting by Lawrence F. Eichenfield, MD, FAAD, a board-certified pediatric dermatologist, chief, division of pediatric and adolescent dermatology and professor of pediatrics and medicine (dermatology), Rady Children’s Hospital and University of California, San Diego School of Medicine.  Dr. Eichenfield is also a member of the National Eczema Association Scientific Advisory Committee.

OVERVIEW
For the millions of children and adolescents affected by chronic skin conditions such as atopic

NIAID Study Offers New Explanation of What Makes an Allergen an Allergen

Using bioinformatics to mine allergen databases and epidemiological studies, investigators at NIAID have uncovered new information on what makes people allergic to allergens. The NIAID team found that the differences between the structure of foreign proteins and the structure of self-proteins made the foreign ones allergenic. The results of their work appear online in the July 18th issue of PLoS ONE.

Background

Allergic diseases, such as asthma, food allergy, and seasonal allergies, affect millions of people in the United States and seem to be on the rise.

A Comparison of Physicochemical Properties of a Selection of Modern Moisturizers: Hydrophilic Index and pH

Abstract

OBJECTIVE:

To quantify and compare the physiochemical properties of various topical emollients and to correlate these findings with the products' potential to maintain the stratum corneum (SC) acid milieu, while possessing the appropriate water content for skin rehydration, user adherence, and comfort.

MATERIAL AND METHODS:

The pH and hydrophilic fraction of 31 skin moisturizers sold in the US were measured. Hydrophilic Index (HI) was calculated using the "HI equation." The two parameters were charted using a scatter plot with quadrant divisions.

Prenatal Exposure to Common Household Chemical Linked to Eczema

Butyl benzyl phthalate is used in vinyl flooring, artificial leather
 
By Mary Elizabeth Dallas

Wednesday, June 27, 2012


WEDNESDAY, June 27 (HealthDay News) -- Babies born to women who were exposed to the common household chemical butyl benzyl phthalate (BBzP) during pregnancy are at greater risk for childhood eczema, new research suggests.

BBzP is used in vinyl flooring, artificial leather and other materials, and can be released into the air, the researchers said.

"While hereditary factors, allergens and exposure to tobacco smoke are known to contribute to the condition, our study is the

Sunscreen Remains a Safe, Effective Form of Sun Protection

SCHAUMBURG, Ill. (May 16, 2012) —The American Academy of Dermatology (Academy) today reiterated the safety and effectiveness of sunscreens to protect against the damaging effects from exposure to ultraviolet (UV) radiation. As one component of a daily sun-protection strategy, sunscreen is an important tool in the fight against skin cancer, including melanoma, the deadliest form of skin cancer.

Unprotected sun exposure is the most preventable risk factor for skin cancer. More than 3.5 million new cases of skin cancer will be diagnosed in the United States this year, affecting 2 million people.

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