Integumentary System Disease: Eczema

Integumentary System Disease: Eczema

03/12/2016

        Eczema is a skin (integumentary system) condition that is a general term for superficial inflammatory process involving the epidermis, which usually becomes red, itching, scabby, and inflamed. There are many types of eczema (atopic dermatitis) (Skinsight,2014):

• Contact eczema: localized reaction where the skin has come into contact with an allergen
• Dyshidrotic eczema: irritation of skin on palms of hands and soles of feet
• Neuro dermatitis: scaly patches on the skin of head, forearms, wrists, lowers legs. Itching in a localized spot such as getting bite by a bug
• Nummular eczema: circular patches of irritated skin that can become crusty, scaling and itching
• Allergic contact eczema: reaction where the skin has come into contact with a substance that the immune system does not recognize

        The cause of eczema is unknown but doctors have narrowed it down to a combination of hereditary and environmental factors. Eczema is also linked to the body’s overactive response by the body’s immune system to an irritant. Some factors that can irritate the eczema are(MNT,2015):

• Irritants: soaps, detergents, shampoos, juices, fruits, meats and vegetables
• Allergens: dust, pollen, dandruff
• Microbes: bacteria such as staphylococcus aureus (a group of bacteria that can cause numerous diseases due to an infection of various tissues of the body,) certain fungi (the most common is Candida which is a strain of fungus that can cause skin infection)
• Environmental temperature: hot temperature causes the skin to become dry which causes the skin to become red and itchy. Cold weather also dries out the skin and the lack of moisture results in the dry, itchy skin.
• Stress: stress can cause the skin to become inflamed which is supposed to protect the skin from harm but if you already have eczema skin inflammation due to stress will cause the eczema to worsen.
• Hormones: Estrogen in women plays a big factor in the eczema condition. With the reduction of estrogen, and the changing ratios of the body hormones reduce the ability for the body to retain moisture.

Eczema is a very common skin disease in the US. Reported there is about 31.6 million people affected with eczema, with one out of three children with eczema/atopic dermatitis. A study had shown that eczema in adults is around 10.2% (MNT,2015).

        The skin has three layers of protection, the epidermis, dermis, and hypodermis. Together those three skin layers act as a skin barrier to protect from any harm such as cuts, pathogens, etc. In healthy skin the skin protectant barrier is resilient and any allergens that try to penetrate deeper into the skin are unable to (Jaliman, 2015). Someone who is affected with eczema is prone to more bacteria and irritants penetrating deep which means the protective barrier is weak and defective. When the skin barrier is defective it decreases the proper level the skin needs to stay hydrated also causing more irritants to take affect such as soap, detergent, house mites, and infections.

Eczema also affects the immune system. The protective barriers of skin help prevent any pathogens from penetrating the skin whereas the immune system fights off any unwanted pathogens that enter the body. When the skin is broken or inflamed in healthy skin the immune system takes action by sending white blood cells to help repair the damage and decrease the amount of inflammation (Jaliman, 2015). Someone with eczema has that itchy feeling in the affected area which means they scratch it. The more irritant, such as scratching, there is to the skin the more inflamed it becomes which results in more white blood cells having to help reduce the amount of inflammation which as a result causes the skin to become more irritated, red and inflamed.

        Eczema has many signs and symptoms which ranges widely from person to person. For some people, eczema flares up periodically such as during season changes. Some signs might include (MNT, 2015):

• Red to brownish color of the skin on the arms, feet, ankles, legs, chest, eyelids, wrists. On infants it can appear of the face and scalp
• Raised, small bumps which may leak fluid creating a scab
• Thick, cracking, dry, scaly skin
• Raw, sensitive, swollen skin from scratching
• Rashes can appear anywhere on the body, in adults and older children, most often found on the neck. Infants may exhibit rash on the torso and face. It usually starts to appears in the areas where the child can rub against sheets
• If eczema appears on the eyes they become red and puffy

The red, inflamed and bumpy skin are common symptoms with the eczema condition. Because eczema causes the skin to be itchy, it causes an individual to scratch it which causes the affected area to become more irritated then the “itch, scratch, sore” cycle begins. In kids that cycle is common because they don’t know better than to not scratch it. Some signs to watch for when it does start to become more serious is (Skinsight, 2014)

• Losing sleep because the affected area is too uncomfortable or distracting from daily routines
• Skin is painful
• Skin starts to become infected (yellow scabs, pus, red streaks)
• When self-care techniques are not working (such as: Aveeno lotions, Boericke and Tafel Florasone Itch and Rash cream)

Eczema does look like a normal rash but to properly diagnosis this condition the dermatologist or doctor needs to begin by taking a look at the skin and will ask questions regarding the symptoms of the skin such as (MedicineNet, 2015):

• Is the rash itchy?
• Is there dry skin with red or scaly rash?
• If the rash has occurred in the past, is the skin thicker in that area?

They will also investigate into family history looking to see if anyone has been diagnosed with eczema or has had similar symptoms. They look into if any blood relatives have had eczema, asthma or hay fever. Some dermatologist perform a patch test (MedicinceNet, 2015). This test is used to find allergies. The patch test involved tiny amounts of allergens on the patient’s skin, then the doctor will check for any irritants. Another test they may perform is a blood test. A small sample of blood is drawn from the arm and tested for high levels of eosinophils, cells in the blood that are part of an immune reaction. Blood levels that are elevated in this test are usually people who are affected with eczema antibody.