I have allergy on my skin what to do

Diagnosis of eczema is based mostly on the history and physical examination.[4] In uncertain cases, skin biopsy may be taken for a histopathologic diagnosis of dermatitis.[28] Those with eczema may be especially prone to misdiagnosis of food allergies.[29]

Patch tests are used in the diagnosis of allergic contact dermatitis.[30][31]

Common types

Diagnosis of types may be indicated by codes defined according to International Statistical Classification of Diseases and Related Health Problems (ICD).

Autoeczematization

Autoeczematization (id reaction, auto sensitization) is an eczematous reaction to an infection with parasites, fungi, bacteria, or viruses.

I own allergy on my skin what to do

It is completely curable with the clearance of the original infection that caused it. The appearance varies depending on the cause.

I own allergy on my skin what to do

It always occurs some distance away from the original infection. (ICD-10 L30.2)

Seborrhoeic

Seborrhoeic dermatitis or seborrheic dermatitis («cradle cap» in infants) is a condition sometimes classified as a form of eczema that is closely related to dandruff. It causes dry or greasy peeling of the scalp, eyebrows, and face, and sometimes trunk. In newborns, it causes a thick, yellow, crusty scalp rash called cradle cap, which seems related to lack of biotin and is often curable.

(ICD-10 L21; L21.0)

Classification

The term «eczema» refers to a set of clinical characteristics. Classification of the underlying diseases has been haphazard with numerous diverse classification systems, and numerous synonyms being used to describe the same condition.

A type of dermatitis may be described by location (e.g., hand eczema), by specific appearance (eczema craquele or discoid) or by possible cause (varicose eczema). Further adding to the confusion, numerous sources use the term eczema interchangeably for the most common type: atopic dermatitis.

The European Academy of Allergology and Clinical Immunology (EAACI) published a position paper in 2001, which simplifies the nomenclature of allergy-related diseases, including atopic and allergic contact eczemas.[32] Non-allergic eczemas are not affected by this proposal.

Venous

Venous eczema (gravitational eczema, stasis dermatitis, varicose eczema) occurs in people with impaired circulation, varicose veins, and edema, and is particularly common in the ankle area of people over 50. There is redness, scaling, darkening of the skin, and itching.

The disorder predisposes to leg ulcers. (ICD-10 I83.1)

Herpetiformis

Dermatitis herpetiformis (Duhring’s disease) causes an intensely itchy and typically symmetrical rash on arms, thighs, knees, and back.

I own allergy on my skin what to do

It is directly related to celiac disease, can often be put into remission with an appropriate diet, and tends to get worse at night. (ICD-10 L13.0)

Dyshidrosis

Dyshidrosis (dyshidrotic eczema, pompholyx, vesicular palmoplantar dermatitis) only occurs on palms, soles, and sides of fingers and toes. Tiny opaque bumps called vesicles, thickening, and cracks are accompanied by itching, which gets worse at night. A common type of hand eczema, it worsens in warm weather. (ICD-10 L30.1)

Atopic

Atopic dermatitis is an allergic disease believed to own a hereditary component and often runs in families whose members own asthma.

I own allergy on my skin what to do

Itchy rash is particularly noticeable on head and scalp, neck, inside of elbows, behind knees, and buttocks. It is extremely common in developed countries and rising.

I own allergy on my skin what to do

Irritant contact dermatitis is sometimes misdiagnosed as atopic dermatitis. Stress can cause atopic dermatitis to worsen.[38]

Neurodermatitis

Neurodermatitis (lichen simplex chronicus, localized scratch dermatitis) is an itchy area of thickened, pigmented eczema patch that results from habitual rubbing and scratching. Generally, there is only one spot. Often curable through behaviour modification and anti-inflammatory medication. Prurigo nodularis is a related disorder showing multiple lumps. (ICD-10 L28.0; L28.1)

Contact

Contact dermatitis is of two types: allergic (resulting from a delayed reaction to an allergen, such as poison ivy, nickel, or Balsam of Peru),[39] and irritant (resulting from direct reaction to a detergent, such as sodium lauryl sulfate, for example).

Some substances act both as allergen and irritant (wet cement, for example).

I own allergy on my skin what to do

Other substances cause a problem after sunlight exposure, bringing on phototoxic dermatitis. About three quarters of cases of contact eczema are of the irritant type, which is the most common occupational skin disease. Contact eczema is curable, provided the offending substance can be avoided and its traces removed from one’s environment. (ICD-10 L23; L24; L56.1; L56.0)

Discoid

Discoid eczema (nummular eczema, exudative eczema, microbial eczema) is characterized by circular spots of oozing or dry rash, with clear boundaries, often on lower legs. It is generally worse in winter. Cause is unknown, and the condition tends to come and go.

(ICD-10 L30.0)

Histopathologic classification

Main article: Histopathologic diagnosis of dermatitis

By histopathology, superficial dermatitis (in the epidermis, papillary dermis, and superficial vascular plexus) can basically be classified into either of the following groups:[33]

  1. Pustular dermatosis
  2. Vesiculobullous lesions
  3. Non vesicullobullous, non-pustular
  1. With epidermal changes
  2. Without epidermal changes.

    These characteristically own a superficial perivascular inflammatory infiltrate, and can be classified by type of cell infiltrate:[33]

  1. Lymphohistiocytic
  2. Lymphoeosinophilic
  3. Mast cell
  4. Lymphoplasmacytic
  5. Lymphocytic (most common)
  6. Neutrophilic

Terminology

There are several types of dermatitis including atopic dermatitis, contact dermatitis, stasis dermatitis and seborrheic eczema.[2] Numerous use the term dermatitis and eczema synonymously.[1]

Others use the term eczema to specifically mean atopic dermatitis.[34][35][36] Atopic dermatitis is also known as atopic eczema.[4] In some languages, dermatitis and eczema mean the same thing, while in other languages dermatitis implies an acute condition and eczema a chronic one.[37]

Less common types

Viral

There are eczemas overlaid by viral infections (eczema herpeticum or vaccinatum), and eczemas resulting from underlying disease (e.g., lymphoma).

Eczemas originating from ingestion of medications, foods, and chemicals, own not yet been clearly systematized. Other rare eczematous disorders exist in addition to those listed here.


Severe allergic reaction (anaphylaxis)

In rare cases, an allergy can lead to a severe allergic reaction, called anaphylaxis or anaphylactic shock, which can be life threatening.

This affects the whole body and usually develops within minutes of exposure to something you’re allergic to.

Signs of anaphylaxis include any of the symptoms above, as well as:

Anaphylaxis is a medical emergency that requires immediate treatment.

Read more about anaphylaxis for information about what to do if it occurs.

Sheet final reviewed: 22 November 2018
Next review due: 22 November 2021

Dermatitis
Other names Eczema
A moderate case of dermatitis of the hands
Specialty Dermatology
Symptoms Itchiness, red skin, rash[1]
Complications Skin infection[2]
Usual onset Childhood[1][2]
Causes Atopic dermatitis, allergic contact dermatitis, irritant contact dermatitis, stasis dermatitis[1][2]
Diagnostic method Based on symptom[1]
Differential diagnosis Scabies, psoriasis, dermatitis herpetiformis, lichen simplex chronicus[3]
Treatment Moisturizers, steroid creams, antihistamines[2][4]
Frequency 245 million (2015)[5]

Dermatitis, also known as eczema, is a group of diseases that result in inflammation of the skin.[1] These diseases are characterized by itchiness, red skin and a rash.[1] In cases of short duration, there may be little blisters, while in long-term cases the skin may become thickened.[1] The area of skin involved can vary from little to the entire body.[1][2]

Dermatitis is a group of skin conditions that includes atopic dermatitis, allergic contact dermatitis, irritant contact dermatitis and stasis dermatitis.[1][2] The exact cause of dermatitis is often unclear.[2] Cases may involve a combination of irritation, allergy and poor venous return.[1] The type of dermatitis is generally sure by the person’s history and the location of the rash.[1] For example, irritant dermatitis often occurs on the hands of people who frequently get them wet.[1] Allergic contact dermatitis occurs upon exposure to an allergen, causing a hypersensitivity reaction in the skin.[1]

Treatment of atopic dermatitis is typically with moisturizers and steroid creams.[4] The steroid creams should generally be of mid- to high strength and used for less than two weeks at a time as side effects can occur.[6]Antibiotics may be required if there are signs of skin infection.[2] Contact dermatitis is typically treated by avoiding the allergen or irritant.[7][8]Antihistamines may assist with sleep and to decrease nighttime scratching.[2]

Dermatitis was estimated to affect 245 million people globally in 2015.[5] Atopic dermatitis is the most common type and generally starts in childhood.[1][2] In the United States, it affects about 10–30% of people.[2] Contact dermatitis is twice as common in females than males.[9] Allergic contact dermatitis affects about 7% of people at some point in time.[10] Irritant contact dermatitis is common, especially among people who do certain jobs; exact rates are unclear.[11]


Pathophysiology

Eczema can be characterized by spongiosis which allows inflammatory mediators to accumulate.

Diverse dendritic cells sub types, such as Langerhans cells, inflammatory dendritic epidermal cells and plasmacytoid dendritic cells own a role to play.[26][27]


Signs and symptoms

Dermatitis symptoms vary with every diverse forms of the condition. They range from skin rashes to bumpy rashes or including blisters.[12] Although every type of dermatitis has diverse symptoms, there are certain signs that are common for every of them, including redness of the skin, swelling, itching and skin lesions with sometimes oozing and scarring.

Also, the area of the skin on which the symptoms appear tends to be diverse with every type of dermatitis, whether on the neck, wrist, forearm, thigh or ankle. Although the location may vary, the primary symptom of this condition is itchy skin. More rarely, it may appear on the genital area, such as the vulva or scrotum.[13][14] Symptoms of this type of dermatitis may be extremely intense and may come and go. Irritant contact dermatitis is generally more painful than itchy.

Although the symptoms of atopic dermatitis vary from person to person, the most common symptoms are dry, itchy, red skin.

Typical affected skin areas include the folds of the arms, the back of the knees, wrists, face and hands. Perioral dermatitis refers to a red bumpy rash around the mouth.[15]

Dermatitis herpetiformis symptoms include itching, stinging and a burning sensation. Papules and vesicles are commonly present.[16] The little red bumps experienced in this type of dermatitis are generally about 1 cm in size, red in color and may be found symmetrically grouped or distributed on the upper or lower back, buttocks, elbows, knees, neck, shoulders, and scalp.

Less frequently, the rash may appear inside the mouth or near the hairline.

The symptoms of seborrheic dermatitis, on the other hand, tend to appear gradually, from dry or greasy scaling of the scalp (dandruff) to scaling of facial areas, sometimes with itching, but without hair loss.[17] In newborns, the condition causes a thick and yellowish scalp rash, often accompanied by a diaper rash. In severe cases, symptoms may appear along the hairline, behind the ears, on the eyebrows, on the bridge of the nose, around the nose, on the chest, and on the upper back.[18]

  1. A patch of dermatitis that has been scratched


Cause

The cause of dermatitis is unknown but is presumed to be a combination of genetic and environmental factors.[2]

Environmental

The hygiene hypothesis postulates that the cause of asthma, eczema, and other allergic diseases is an unusually clean environment in childhood which leads to an insufficient human microbiota.

It is supported by epidemiologic studies for asthma.[19] The hypothesis states that exposure to bacteria and other immune system modulators is significant during development, and missing out on this exposure increases the risk for asthma and allergy.

While it has been suggested that eczema may sometimes be an allergic reaction to the excrement from home dust mites,[20] with up to 5% of people showing antibodies to the mites,[21] the overall role this plays awaits further corroboration.[22]

Genetic

A number of genes own been associated with eczema, one of which is filaggrin.[4] Genome-wide studies found three new genetic variants associated with eczema: OVOL1, ACTL9 and IL4-KIF3A.[23]

Eczema occurs about three times more frequently in individuals with celiac disease and about two times more frequently in relatives of those with celiac disease, potentially indicating a genetic link between the conditions.[24][25]


Prevention

Only breastfeeding during at least the first few months may decrease the risk.[40] There is no excellent evidence that a mother’s diet during pregnancy or breastfeeding affects the risk.[40] Nor is there evidence that delayed introduction of certain foods is useful.[40] There is tentative evidence that probiotics in infancy may reduce rates but it is insufficient to recommend its use.[41]

Certain military and healthcare personnel who might come into contact with the smallpox are still vaccinated against the virus.[42] Those who also own eczema should not get the smallpox vaccination due to risk of developing eczema vaccinatum, a potentially severe and sometimes fatal complication.[43]


Main allergy symptoms

Common symptoms of an allergic reaction include:

  1. tummy pain, feeling ill, vomiting or diarrhoea
  2. itchy, red, watering eyes (conjunctivitis)
  3. a raised, itchy, red rash (hives)
  4. swollen lips, tongue, eyes or face
  5. wheezing, chest tightness, shortness of breath and a cough
  6. sneezing and an itchy, runny or blocked nose (allergic rhinitis)
  7. dry, red and cracked skin

The symptoms vary depending on what you’re allergic to and how you come into contact with it.

For example, you may have a runny nose if exposed to pollen, develop a rash if you own a skin allergy, or feel sick if you eat something you’re allergic to.

See your GP if you or your kid might own had an allergic reaction to something. They can assist determine whether the symptoms are caused by an allergy or another condition.

Read more about diagnosing allergies.


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