Definition Eczema (or dermatitis) refers to a group of chronic skin disorders that primarily involve the epidermis. This chronic, superficial inflammation of the skin is often seen in children with a family history of allergic rhinitis, asthma or atopic dermatitis. There are a number of different types of eczema commonly seen in children, including the following: Contact eczema: localized rash where offending agent has touched the skin; caused by allergens, irritants, light, chemicals, perfumes, metals. Neurodermatitis: this term is used to describe eczematoid rashes that seem to have a major stress-related component. Atopic eczema: this is most common in patients with a history of other allergic conditions (e.g. asthma, hay fever). Atopic eczema (also known as atopic dermatitis and/or childhood eczema) is the most prevalent eczema seen in clinical practice in children: it affects 10-20% of infants. Affected children exhibit dry, itchy skin with eruptions. Atopic eczema has an immunological basis: this Type I allergic reaction is associated with the IgE antibody production. Most atopic eczema patients exhibit a deficiency in delta-6-desaturase (the enzyme that converts linoleic acid to gamma-linolenic acid) and most atopic eczema patients exhibit glutathione peroxidase deficiency.
Aetiology / Risk Factors Major causative factors and risk factors that can contribute to the eczema include: Family history of allergies. Personal history of allergies. Digestive disorders (e.g. hydrochloric acid deficiency). Dysbiosis and/or liver toxicity. Exposure to environmental allergens and/or toxic compounds. Nutritional deficiencies – especially EFA's. Excessive consumption of fruit – especially citrus fruits. Stress or anxiety. Lack of sleep.
Symptoms & Signs Common signs and symptoms of eczema include the following: Dry, red, inflamed skin lesions that appear on face, neck, trunk and particularly flexures of elbows and knees. Itching and/or oozing and crusting of lesions. Blistering of skin, particularly on the hands and feet. Skin can become wet and weepy if it gets infected. Scaling of areas of skin that are scratched frequently - this is known as lichenification.
Diet and Lifestyle Dietary and lifestyle guidelines that may assist in the management of eczema include the following: Reduce exposure to endogenous and exogenous antigenic material, using the ABO Blood Type Diet. An ABO blood type diet may reduce the possibility of consuming allergens which may cause digestive upsets, food sensitivities, or allergic reactions in the infant/child. A blood type diet will also help to reduce sugar cravings and balance blood sugar levels. Eliminate all food allergens from the diet. The most common allergenic foods are dairy, soy, citrus, peanuts, wheat, fish, eggs, corn, and tomatoes. An elimination/challenge trial may be helpful in uncovering sensitivities. Remove suspected allergens from the diet for two weeks. Reintroduce foods at the rate of one food every three days. Watch for reactions that may include gastrointestinal upset, mood changes, flushing, and exacerbation of eczema. A rotation diet, in which the same food is not eaten more than once every four days, may be helpful in chronic eczema. Reduce inflammatory foods in the diet including saturated fats (meats, especially poultry, and dairy), refined foods, and sugar. Increase intake of fresh vegetables, whole grains, and essential fatty acids (cold-water fish, nuts, and seeds). Avoid the use of soaps, detergents and perfumed products on the skin. Keep the skin nourished with oils using an omega oil, olive oil or vitamin E. Exposure of afflicted areas of the skin to sunlight may alleviate (atopic) eczema (due to the UV-B component of sunlight). Hypersensitivity reactions may be associated with stress and anxiety. Counselling and/or stress management may help reduce reactivity.
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