Thursday, March 29, 2012

Ezema Questions Answered, with Pics!

Most people hit my blog because they're looking for images of things. I started the blog to answer questions and relate my experience with the disease TRAPS. And loads of people come to the blog for some insight into it. In fact, I'm fairly certain they're hitting the site for TRAPS answers because it's on some homework they're doing.

Note to students: If you're looking for an interesting disease to present, choose TRAPS. If you're looking to get an A, go with Eczema.

And, note to Rheumatologists treating TRAPS: Colchicine DOESN'T work. Please stop torturing your patients!!

Alright, now, one of my most favourite hobbies: Answering Questions!

Today's topic is Eczema.

My husband thought this query was rather hilarious, but I imagine the people googling don't.

1) Eczema on my Balls

Firstly, go to this page.

Can you get eczema on your testicles? The short answer is yes. If you have skin, you can get eczema on it.

How can you tell it's eczema? Well, this is where it gets harder. (Pun fully intended)

Because the skin around the testicles is damp, warm and the atmosphere is pretty dark and humid, it may not be eczema. It fully could be, but you're probably looking at a more yeast based issue.

If it's red, puffy, oozy and warm, it's most likely a yeast based issue. An antifungal cream and a diet rich in garlic, yoghurt and apple cider vinegar will help. You need to look into an anti-candida diet and cut out your sugars! People who get recurrent yeast infections, who aren't on long-term drugs like steroids, generally can blame a candida overgrowth and too much sugar.

For those of us on long-term steroids, the problem is probably the steroid. It can make you sweat heaps and sweat, humid and damp places = candida.

If it's not red, puffy and oozy, and the skin is peeling and raw, well that's when you need to see a doctor. It probably needs to be swabbed and you might need to be sent to a dermatologist. It could be eczema or even psoriasis.

What is the treatment?

Well, it's going to depend on what's triggering the eczema.

Most likely soap or chemicals. If you work out, play sports or are generally more sweaty, you probably shower a lot and use a chemical laden body wash or soap to 'kill germs' and 'reduce smell'. And it's probably making your skin dry. Dry skin in that humid atmosphere probably produces the itchy rash or the peeling, dry skin.

Go to a non-chemical based (or 'eco') product, use a non-chemical (or 'eco') body lotion and see how it goes. If it doesn't get better in a few days, it needs to be seen by a dr.

You need to change detergents that touch your skin. That means hand soaps, laundry detergents and you need to stop using fabric softener or dryer sheets. You need to change the cleaning products in the house. The issue is, if you have eczema there, you might also have it behind your knees or on your back. Go for the non-chemical versions and you will notice a difference in your skin.

Even if your style of eczema is triggered by stress or food allergies, eliminating chemicals from your skin will help your overall health. Those chemicals seep into your skin, into your body and your body will naturally react. Those with eczema of *any* type are most prone to chemical sensitivities.

Who gets eczema on their testicles?

Mostly babies. Again, it's a chemical reaction or a reaction to dairy or lactose. I imagine people who play sports, exercise a lot or are generally more sweaty will probably be at risk. As are those who are on long-term drug therapies.

What does it look like?

Well, I'm not going to prop up a picture of testicles (<--- That's eczema on the penis, be forewarned), so I'll show you eczema.

2) Types of Eczema

Atopic Eczema -- "Atopic eczema can flare up and then calm down for a time, but the skin tends to be dry and itchy even in-between flare ups. It often affects the creases of body joints, such as the backs of the knees or inside the elbows, but in black skins the eczema often affects the front of the knees and elbows. Atopic Eczema can occur in small patches or all over the body.

Spontaneous flare-ups are often the result of triggers. Triggers are not the same for everyone, but there are a number of common ones:

* Soap and detergents
* Skin Infection
* House-dust mites and their droppings
* Animal dander (fur, hair) and saliva
* Pollens
* Overheating
* Rough clothing

Many people with atopic eczema find that there is a connection between eczema and stress although whether the stress causes the eczema or vice versa is less clear." -- *

Contact Dermatitis -- 'Contact eczema, or contact dermatitis as it is more commonly referred to, is the name given to those types of eczema that occur as a result of contact with irritants or allergens in the environment.
Contact dermatitis affects 9% of the UK population and is the most common type of work related skin disease (also known as occupational skin disease).

There are two types of contact dermatitis:

Irritant Contact Dermatitis

Irritant contact dermatitis is a reaction to frequent contact with everyday things which irritate the skin, such as soap, detergents, hair cosmetics, bleach, cold wind and raw food. Common sites for irritant contact dermatitis are the hands and face, but the condition can affect other parts of the body. A person who had atopic eczema as a child is at an increased risk of developing irritant contact dermatitis.

Symptoms of irritant contact dermatitis may range from mild dryness and skin redness to the appearance of skin burns. It can be painful, red, fluid-filled and ulcerated. Weak irritants, for example, diluted acids, diluted alkalis, solvents, soaps, detergents, metallic salts, cement, resins and cutting fluids are the commonest cause of irritant contact dermatitis.

Occupations at greatest risk of developing irritant contact dermatitis include: chefs, hairdressers, metal workers, nurses, cleaners and construction workers.' *

Allergic Contact Dermatitis

'Allergic contact dermatitis is much less common than irritant contact dermatitis. Minute quantities of apparently harmless substances may cause severe allergic contact dermatitis.

Allergic dermatitis is caused by an individual developing a specific allergy to a chemical. For allergy to develop, repeated exposure to the chemical is required over a period of time, usually months or years. Once this has happened, the body’s defence mechanisms learn to recognise the chemical and the individual develops a reaction when the chemical contacts the skin again. The allergy is ‘remembered’ by the body for many years. In medical terms the body has become ‘sensitised’ to a chemical.

The reaction can be immediate or delayed depending on the type of allergen in question. Most frequently seen on the hands, allergic contact dermatitis can cause the skin to become dry, red, split, cracked, weeping, fluid filled and intensely itchy, sore, painful and stinging. The severity will depend upon the allergen and the length of time it is in contact with the skin.' *

Gravitational or Varicose Eczema

'This type of eczema is common later in life, particularly in women. If you have poor circulation, have had a blood clot in your legs, have varicose veins or are overweight you are at risk of developing gravitational eczema (also known as varicose or stasis eczema).

Poor circulation means that the blood moves less well up our veins towards the heart. The resulting increase in pressure weakens the vein walls causing fluid to pool in the lower legs making the ankles swell. Blood may then leak through the very small vessels in the legs, causing a dark red or brown patch under the skin. Over a period of time the skin becomes very thin and fragile on the lower legs and can easily break down, leading to an ulcer.

When gravitational eczema is severe the skin can have weeping, crusted areas which can quickly get bigger and become a varicose leg ulcer.

A leg ulcer is a small hole in the skin which can deepen and widen and become very sore. Because of the nature of the wound it can easily become infected and can be difficult to heal especially in those with poor circulation.' *

Pompholyx Eczema

'Also known as dyshidrotic eczema, the key characteristic of this form of eczema is blistering that is restricted to the hands and feet. In particular, the sides of fingers, palms of hands and soles of feet are affected although it can combine with other types of eczema elsewhere on the body. Pompholyx accounts for 5-20% of all cases of hand eczema.

The blisters can break and cause weeping and the skin is very itchy and inflamed. Peeling can occur as the skin dries out. The cause is not known, although factors such as emotional tension, a sensitivity to metal compounds such as nickel, cobalt, chromate, or heat and sweating can aggravate this type of eczema.' *

Discoid or Nummular Eczema

'Also known as nummular dermatitis, this type of eczema is usually seen in adults with dry skin although it can affect teenagers and young children, but this is rare. It is very distinct with ‘coin shaped’ discs of eczema the size of a fifty pence piece that start off slightly bumpy, usually on the lower legs, trunk or forearms. Within a few days the patches begin to ooze, and can become very itchy, crusted and infected.

Later on, the surface becomes scaly and the centre of the discs clears, leaving the skin dry and flaky. Like most types of eczema the exact cause is not clear, although dry skin is perhaps the most common feature seen in people with this condition. Other factors include the use of soaps and detergents, and previous experience of eczema.' *



Asteatotic Eczema

Also known as “eczema cracquel√©e”, this type of eczema almost always affects people over the age of 60. The cause is not known but asteatotic eczema can be linked to a decrease in the oils on the skin surface, low humidity, over cleansing of the skin, hot baths, scrubbing the skin and vigourous towel drying. Pre-existing dryness and roughness of the skin are also linked to this type of eczema.

Asteatotic eczema initially appears on the shins with a ‘crazy paving’ appearance. Fissures or grooves can appear which look pink and red, but tend to only affect the superficial layers of the skin. Other areas that can be affected are upper arms, thighs and lower back but it is usually linked to the legs. It can cause a great deal of discomfort including soreness and itching. *

Seborrhoeic Dermatitis / Eczema

'Seborrhoeic eczema in adults

Adult seborrhoeic eczema usually starts on the scalp as dandruff that can progress to redness, irritation and increased scaling, which becomes seborrhoeic eczema. As the scalp becomes inflamed, the eczema may spread onto the face and neck. Eyebrows, temples, folds at the sides of the nose, and neck are often affected – the area looks red and sheds small white flakes of skin. Seborrhoeic eczema can be particularly bad behind the ears – larger, greasy scales stick to the skin and surrounding hair, making the area look thickly crusted. The ear folds and canal may also be affected, causing irritation inside the ear, which is called ear eczema.

Seborrhoeic eczema often occurs only on the scalp and face, but it can extend to the centres of the chest and back, especially in men. Other areas which can also be affected are the armpits, under the breasts, groin and between the buttocks and genitals.

The cause of seborrhoeic eczema is not entirely clear. However, it has come to light that a yeast called pityrosporum ovale (also known as malassezia furfur) is found on the skin of people with seborrhoeic eczema. At present it is not clear if this yeast is the sole cause or merely a contributing factor to seborrhoeic eczema however it thrives in areas of the body where there are increased numbers of sebaceous glands.

Unfortunately, seborrhoeic eczema does tend to return at intervals, especially when treatment is stopped. With treatment the condition can be successfully controlled in most cases so that the skin and scalp are comfortable much of the time.' *

'Seborrhoeic eczema in children

Childhood seborrhoeic eczema is usually seen in infants under the age of one, seborrhoeic eczema can appear quite suddenly between two and six months after birth. Often the nappy area is affected first, however, it tends to spread fairly rapidly so that the scalp, face, neck, armpits and sometimes even the trunk are soon affected – this may seem rather alarming but don’t worry, it will soon improve!
In the nappy area, the skin looks red, inflamed and flaky – the surface may also feel bumpy due to tiny blisters. The skin scales in this area are small and white, and tend to rub off easily making the skin look shiny. Sometimes it spreads up the body and down the legs, when small round or oval patches are seen, which later join together to form larger red areas.

On the scalp, the scales are larger, greasy and yellowish – they tend to stick to the head making it look crusted. The forehead, temples, eyebrows, back of neck, behind the ears and folds at the sides of the nose are often also affected.

Childhood seborrhoeic eczema is not usually itchy, sore or uncomfortable, so your baby should feed, play and sleep as usual, and hopefully be undisturbed by it.' *

3) Eczema in African Americans

Eczema is considered the 2nd most prevalent skin condition in African Americans, yet, when you go researching, the majority of pictures feature white skin. I can't imagine how frustrating that must be if you are an African American mum looking for photos of eczema on your baby.

If you are African American and looking for resources, head over to Brown and Beautiful Brown Skin. Fabulous sites.

An issue concerning a lot of African American women with eczema is hyperpigmentation. Ronald Shelton, MD states: "Especially with a history of eczema, there is a liklihood of developing postinflammatory hyperpigmentation, thickening of the skin from chronic rubbing secondary to severe itching, and possibly iron staining of the skin from red blood cells that leak out into the dermis." *


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