Medical Assessment
Eczema: A Chronic Inflammatory Skin Condition
Eczema affects approximately 20% of children and 3% of adults worldwide. It is a chronic inflammatory skin disease that is extremely itchy, often irresistible to scratch, and characterized by recurrent flare-ups at varying frequencies. The condition presents with both dry and wet states, leading to cycles of dry skin, flaking, weeping, bleeding, or crusting, followed by periods of relief. Over time, the chronic nature of the disease can cause the skin to become lichenified, thickened, and pigmented.
There are several different types of eczema, with Atopic Dermatitis being the most common form. Other types of eczema include Contact Dermatitis, which is triggered by contact with irritants or allergens, and Stasis Dermatitis, which typically affects the lower legs and is associated with circulatory problems.
Causes of Eczema
Currently, there is no known single cause for eczema. In fact, there are many types of eczema, each with at least one contributing factor, if not more. Some of the most common causes include a family history of eczema, exposure to certain environmental triggers, and stress, among others. To learn more about the causes of eczema, click here. <Causes of Eczema>
Doctor's Assessment: Diagnosing Eczema The diagnosis of eczema is based on the patient's medical history and clinical/physical examination. The following table summarizes the characteristics to consider when making a diagnosis:
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410183/
The diagnosis of eczema is primarily based on the patient's medical history and a clinical/physical examination. The key features typically assessed include:
基本濕疹特徵(必須呈現): 搔癢、濕疹表徵(急性、亞急性、慢性)、復發史、典型的形態(如:嬰兒小孩的臉部頸部、皮膚折叠的地方、手肘內側、膝蓋後方、腹股溝...等)
重要濕疹特徵(在大多數情況下可見): 年輕發病、有個人和/或家族史、IgE 水平升高、皮膚乾燥症(皮膚乾燥、鱗屑、龜裂...等)
相關濕疹特徵(或有助於參考診斷, 但非典型, 無法用於定義診斷): 非兼型血管反應、毛囊角化症、白色糠疹...等等
排除條件(確立濕疹診斷必須排除以下條件/ 皮膚病): 其他發炎性皮膚病、脂漏性皮膚炎、牛皮癬、接觸性過敏、汗皰、魚鱗病、其他感染或侵染如: 疥癬、體癬、玫瑰糠疹、或其他免疫缺、免疫系統疾病...等等
嬰兒脂漏性皮膚炎常被誤認為是濕疹。然而它並不搔癢, 並會導致乳痂和皮膚皺褶處出現潮濕的紅色區域; 一般來說 6個月後往往會有所改善。
Reference:
Eichenfield, Lawrence F et al. “Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis.” Journal of the American Academy of Dermatology vol. 70,2 (2014): 338-51. doi:10.1016/j.jaad.2013.10.010
American Academy of Dermatology Association https://www.aad.org/public/diseases/eczema/types/atopic-dermatitis
Guidelines for the diagnosis and assessment of eczema https://dermnetnz.org/topics/guidelines-for-the-diagnosis-and-assessment-of-eczema
National Eczema Association https://nationaleczema.org/eczema/
British Association of Dermatologists https://www.bad.org.uk/pils/atopic-eczema/
