Eczema in the baby

The most common form of eczema in babies is atopic eczema, better known as neurodermatitis. However, this term is misleading in that it implies that there is an inflammation of the nerves. In Germany, up to 15% of children fall ill with neurodermatitis by the time they start school, 60% of them in the first age.

Thus, atopic eczema is the most common skin disease in children. The development is multifactorial, whereby genetic predisposition, immunological changes and environmental influences such as the child’s diet (e.g. cow’s milk is suspected to be the trigger) seem to play a role. Atopic eczema is characterized by very dry and sensitive skin, especially on the face and neck, as well as on the arm and knee bends.

However, the most tormenting thing for the babies is an often very strong itching, which leads to the children scratching the diseased skin areas permanently. In babies, the so-called milk crust on the scalp can be an early form of atopic eczema. The disease usually progresses in relapses and can take on quite different forms and dimensions, ranging from harmless to severe. The treatment must be adapted accordingly.

Eczema according to its form

Astetatotic eczema is also called desiccation eczema or desiccation dermatitis. It is an eczema that occurs due to a reduced fat content of the skin. So-called lipids (fats), protect the skin from dehydration and are therefore very important for a healthy skin barrier.

The lack of lipids therefore causes inflammation of the skin. Asteatotic eczema is a chronic eczema that is particularly common in older people due to the fact that drugs such as isotrentinoin, bevacizumab or indinavir promote skin dehydration. Eczema usually occurs from the age of 60 onwards and often worsens in winter.

Affected are mainly the extensor sides of the arms, the shins and the trunk. Asteatotic eczema is similar to a “dried out river bed” with The therapy of asteatotic eczema is based on oily skin and the application of cortisone ointments on the affected area to control the inflammation.

Wrong or excessive personal hygiene or
As an undesirable side effect when taking medication.
Deep cracks in the skin,
Scaling and
Superficial bleeding due to scratching by the affected person.

Atopic eczema is often referred to in the vernacular as neurodermatitis.

It is a chronic inflammatory skin disease, which usually occurs in childhood and is accompanied by a disruption of the skin barrier.It is assumed that over 13% of children in Germany suffer – at least temporarily – from atopic eczema. By early adulthood, about two thirds of the originally affected children are symptom-free again. In adulthood, about 2 to 3% seem to be affected by atopic eczema.

Typical for atopic eczema Atopic eczema is associated with further typical changes, which are also called stigmata of atopy. Among these changes are In most cases, atopic eczema occurs in combination with allergies. These are mainly food allergies.

A very dry skin, which tends to severe itching and eczema. Eczema can be found in adults and adolescents, especially in the crooked sides, on the neck, the backs of the hands and the skin folds. In infancy, however, the localization differs somewhat and the eczema is mainly found as so-called milk crust on the scalp and further on the extensor sides of the arms and legs, as well as on the face.
Characteristic for the strongly itchy eczema is the tendency to redness and crust formation.
Scratching the skin causes cracks and, if the process is prolonged, hyperpigmentation, so that the skin appears darker.
A deep hairline,
A double lower eyelid crease -so-called Dennie Morgan sign-,
A thinning of the lateral eyebrow (Hertoghe sign) and
Fading of the skin when pressure is applied to it (white dermographism).

The therapy of atopic eczema includes a step-by-step therapy that is adapted to the severity of the eczema.

Every affected person receives a basic care with refatting and water-binding creams to strengthen the skin barrier.
Furthermore, trigger factors of eczema, such as special foods or scratchy clothing, should be avoided.
In the second stage of therapy, topical cortisone creams, disinfectant lotions and tablets that inhibit itching (antipruriginosa ) and topical calcineurin inhibitors are used. The latter are drugs that regulate the immune system.
Light therapy is also possible at this stage of the therapy.
As an extreme measure, a systemic immunoregulatory therapy with tablets or injections can be performed. Commonly used drugs include Ciclosporin, Azathioprine, MMF and also oral cortisone preparations.
For some time now, there have also been newer drugs known as biologicals.
These are only approved for severe forms of atopic eczema.

Dyshidrotic eczema is an eczema that affects the palms of the hands and soles of the feet and usually occurs in relapses. Characteristic for dishydrotic eczema is the appearance of vesicles of about 0.1 cm in size with a clear content. The dishydrotic eczema can occur in the context of different basic illnesses, as for example Further the cause is often unexplained, then one speaks of an idiopathic dyshidrotic eczema.

The eczema occurs predominantly in the warm season. The small, clear blisters, which are characteristic for eczema, usually appear suddenly and grouped on the sides of the fingers and palms – similarly also on the feet. The blisters are very itchy.

When the blisters merge to form larger blisters, one speaks of a pompholyx. In this case, a bacterial or mycotic (fungal) infection of the eczema can develop as a complication. Dyshidrotic eczema is treated with cortisone tablets.

Of an atopic eczema,
Psoriasis palmoplantaris or
A mycosis can occur.
It can also be used for allergic contact dermatitis or
As a drug side effect occur.
Local cortisone preparations,
Light therapy and
Care of the affected areas.

Allergic contact dermatitis is caused by contact of the skin with a triggering allergen. A typical allergen to which many people react is nickel, for example. Therefore, jewelry is nowadays almost without exception produced without nickel.

Other common allergens are fragrances, perubalm, chrome and cobalt. The allergic contact eczema is one of the most common diseases in Germany.Typically occurs after about 24 to 48 hours after contact with the allergen A very severe reaction occurs If the allergen repeatedly comes into contact with the skin, chronic eczema develops, characterized by scaly plaque formation with crusts and erosions as well as a coarsening of the skin texture The therapy of allergic contact eczema includes above all the avoidance of the allergen, as well as local cortisone preparations.

Usually blurred, red plaque on,
The strongly itches and
Rises above the skin level.
Big bubbles, the
Bursting and crusts as well as erosion are left behind.

Irritant contact dermatitis is often referred to as toxic contact dermatitis.

It is a direct damage to the skin due to an external cause, such as contact with an acid. In over 90% of cases, the hands are affected, less frequently the feet. Acute eczema is caused by direct contact with a sufficient dose of the triggering substance.

Chronic irritant contact eczema develops as a gradual consequence of constant contact with a substance that is only slightly toxic. These can be household cleaning products, for example. Over a longer period of time, the skin barrier is damaged.

Typically, it is a sharply defined eczema that only occurs at the point where the skin has had contact with the toxic substance. The appearance of eczema includes The therapy consists of strict avoidance of the triggering cause, as well as local treatment with ointments containing cortisone. If an occupational disease is suspected, an occupational physician procedure must be initiated and appropriate safety precautions must be taken at the workplace.

Acute from
Chronic irritant contact dermatitis.
Scaling,
Redness,
Crusts,
Tears and
A blistering.

Nummular eczema typically shows therapy-resistant, coin-shaped, scaly plaques, which are sometimes very itchy. The plaques are found all over the body and can occur as a concomitant symptom of congestive dermatitis. The exact cause of nummular eczema is generally unclear.

A connection to clinical pictures such as atopic eczema, psoriasis or chronic microbial colonization of the skin is being discussed. Men are more frequently affected than women and show eczema mainly on the lower legs and less frequently on the thighs, back and palms. There is no uniformly effective therapy for nummular contact dermatitis.

Therapy with oral antibiotics and local cortisone preparations can be used. In severe forms of eczema, additional light therapies and internal cortisone therapy may be considered. Seborrheic eczema mainly affects men between the ages of 40 and 60 and is more common in HIV and Parkinson’s disease patients.

It is caused by an interaction of excessive sebum production of the skin and overgrowth of the yeast fungus Malassezia furfur. Eczema improves with sunlight and worsens with stress. Typically, it occurs in areas with increased sebum production, such as: The eczema shows coin-shaped, reddened foci with a yellow-greasy scaling.

Sometimes severe itching occurs – especially if the scalp is affected. Frequently, seborrhoeic eczema is a diagnosis of the eye. In very young patients with a pronounced seborrhoeic eczema, HIV diagnostics should be performed, since seborrhoeic eczema is more common in HIV.

The therapy includes the use of creams or shampoos with the fungicidal active ingredient ketoconazole, as well as stays in the fresh air and sun. If the spread of the disease is very severe, local cortisone preparations can be used. In most cases, long symptom-free intervals can be achieved.

However, it is not possible to cure eczema, so that the skin changes are always spreading. A special form of eczema is seborrhoeic infant eczema, also known as head gneiss. Eczema mainly affects the scalp and occurs immediately after birth.

It disappears by itself after a few months. Seborrheic infant eczema should not be confused with milk crust, which usually appears only after the third month of life and is accompanied by itching.

The hairy scalp,
The front and rear welding gutter,
The cheeks,
Behind the ears and
The nose and mouth region on.

Disseminated eczema is one of the extremely rare forms of eczema.

However, women are even less frequently drunk from this form than men.In disseminated eczema, a wide variety of affected skin areas occur, especially on the arms and legs. In most cases, the symptoms reoccur repeatedly even after treatment.

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