By Fry L.
During this concise atlas, Fry (emeritus, Imperial university) starts off with dialogue of the definition and occurrence of atopic eczema and follows with information regarding reports that show a rise in prevalence and a dating among eczema and the chance of constructing bronchial asthma and hay fever. He seems to be on the position of genetic elements and result of dual reviews and genome monitors; the histological good points of acute, subacute and protracted eczema; and etiological elements, together with attainable genetic applicants, allergens and contributory elements reminiscent of pollutants and the ''hygiene hypothesis.'' the ultimate chapters contain well-illustrated descriptions of medical positive factors and differential analysis, and a wide dialogue of remedy, which include topical medicinal drugs, organic brokers, and measures which can relief in administration (e.g. behind schedule advent of yes meals and alteration of maternal diet).
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Extra info for An Atlas of Atopic Eczema
Fortunately, with the advent of effective antiviral drugs (aciclovir, famciclovir) against herpes simplex virus, eczema herpeticum now has a better prognosis. If the disease is suspected on clinical grounds, it is important to start antiviral treatment immediately and not wait for laboratory confirmation of the infection. It is also advisable to commence antibacterial therapy at the same time because of possible secondary infection with S. aureus. 36 AN ATLAS OF ATOPIC ECZEMA Figure 31 Extensor surface involvement on the knees in an infant.
Involvement of the face (Figures 53–55), particularly around the eyes, is another presentation. The eyelids and surrounding skin are red, swollen and scaly (Figures 53 and 54). Patches or confluent involvement on the neck also occur (Figures 56 and 57). Occasionally in severe disease, the eczema is generalized and the skin is red, scaly and lichenified all over. This is sometimes referred to as erythroderma (Figure 58). NON-AGE-RELATED FEATURES Symmetry As with other forms of endogenous skin disease, atopic eczema tends to be a symmetrical eruption (Figures 31, 37–40, 43, 49, 52).
Approximately 25–30% of patients with atopic eczema will develop asthma at some stage of their life. In half of these, allergic rhinitis also occurs. The asthma commences before the age of 5 in one-third of those that develop the condition. 32 AN ATLAS OF ATOPIC ECZEMA Figure 27 Confluent atopic eczema with erythema and scaling on the back. Some scaling of the scalp is also present Allergic rhinitis (hay fever) This will subsequently occur in 50% of patients with atopic eczema and usually begins between the ages of 10 and 30, which is considerably later than atopic eczema.