Pak David, Yang bapak maksudkan adalah Ezcema ya? AKA Dermatitis Atopis? Ada sedikit artikel tentang ini, saya kumpulkan sejak anak saya terkena ezcema.
Melisa =============================== FOR IMMEDIATE RELEASE November 3, 2003 Contact ---------------------------------------------------------------------------- ---- Winter's Itch The AAAAI offers advice on the symptoms and treatments of eczema MILWAUKEE- The allergy season is usually associated with sneezing, wheezing and runny noses. But did you know that allergies can cause an itchy rash? Atopic dermatitis, or eczema, is a common allergic reaction that can affect your skin. About 9 percent of the U.S. population is affected by atopic dermatitis, and the prevalence appears to be increasing, according to the American Academy of Allergy, Asthma and Immunology (AAAAI). Eczema is most common in children, but can also occur later in life for people who have a history of asthma or allergic rhinitis. Signs of eczema can be: a.. Very dry skin b.. "Oozing" skin c.. Skin looks like a red, itchy, scaly rash The severity of the rash will depend on how bad your allergy is. "Prevention is the main treatment for this allergic skin condition. By avoiding your trigger, you can avoid the uncomfortable rash all together," said Donald W. Russell, MD, FAAAAI, chair of the AAAAI Urticaria and Angioedema Committee. "Keeping your skin lubricated with lotions and creams, especially during dry seasons, such as winter, will help to lock the moisture in your skin and protect against future rashes." Common triggers are: a.. Overheating or sweating b.. Contact with irritants such as - wool - pets - soaps - food Sometimes avoiding your trigger is not always possible, especially if you do not know what it is. If you do have a reaction, try not to scratch or rub the rash. You can apply cold compresses and lubricate the dry skin with a cream or an ointment. "Since eczema is most common in children, parents should be especially aware of the triggers that cause a child's rash," Russell said. Food is one of the main culprits for children, so make sure you discuss with your allergist/immunologist that possibility if you see these symptoms. Eczema can make children irritable and cranky, so finding the trigger as soon as possible will be beneficial to the whole family. An allergist/immunologist can help you determine what your triggers are if you don't know. There are three main signs physicians look for when diagnosing eczema: a.. Itchy skin b.. Bubbly rash c.. Previous allergy history If one of these three things is missing, your skin condition may be caused by something else. Your physician can prescribe a wide variety of treatments as well as over-the-counter medications. There are topical medications, such as cortisone creams, ointments and lotions that can help ease your rash. Although these are the most common way to cure the rash, oral medications such as antihistamines or oral corticosteroids will aid in relieving the itch. In worst case scenarios, where the itching has led to an infection, antibiotics will be prescribed. Whenever you have an unusual rash, make sure you contact your allergist/immunologist. By taking a full history and running a few tests, your physician can help determine what is the cause of the rash - whether it is allergies, an irritant or some other trigger. To find an allergist/immunologist in your area or to learn more about allergies and asthma, call the AAAAI Physician Referral and Information Line at (800) 822-2762 or visit the AAAAI Web site at www.aaaai.org. The AAAAI is the largest professional medical specialty organization in the United States representing allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Allergy/immunology specialists are pediatric or internal medicine physicians who have elected an additional two years of training to become specialized in the treatment of asthma, allergy and immunologic disease. Established in 1943, the AAAAI has more than 6,000 members in the United States, Canada and 60 other countries. The AAAAI serves as an advocate to the public by providing educational information through its Web site at www.aaaai.org. ================================= Eczema and Dermatitis Eczema is a general term used to describe a number of different skin conditions. It usually appears as reddened skin that becomes moist and oozing, occasionally resulting in small, fluid-filled bumps. When eczema becomes chronic (persists for a long time), the skin tends to thicken, dry out and become scaly with coarse lines. The two main types of eczema are atopic dermatitis and contact dermatitis. Atopic dermatitis often occurs in infants and children who have allergies or a family history of allergy or eczema, although the problem is not necessarily caused by an allergy. Atopic dermatitis usually develops in three different phases. The first occurs between 2 and 6 months of age, with itching, redness, and the appearance of small bumps on the cheeks, forehead or scalp. This rash may then spread to the arms or trunk. In many cases, the rash disappears or improves by 2 or 3 years of age. The second phase of this skin problem occurs most often between the ages of 4 and 10 years, and is characterized by circular, slightly raised, itchy and scaly eruptions on the face or trunk. These are less oozy and more scaly than the first phase of atopic dermatitis, and the skin tends to appear somewhat thickened. The most frequent locations for this rash are in the bends of the elbows, behind the knees, and on the backs of the wrists and ankles. This type of eczema is very itchy, and the skin generally tends to be very dry. The third phase, characterized by areas of itching skin and a dry, scaly appearance, begins at about age 12 and occasionally continues on into early adulthood. Although there is no cure for atopic dermatitis, it generally can be controlled and often will go away after several months or years. The most effective treatment is to prevent the skin becoming dry and itchy. To do this: a.. Avoid frequent long, hot baths, which tend to dry the skin b.. Use skin moisturizers (e.g., creams or ointments) regularly and frequently to decrease the dryness and itchiness c.. Avoid harsh or irritating clothing (wool or coarse-weave material) d.. If there is oozing or exceptional itching, use tepid (lukewarm) compresses on the area, followed by the application of prescribed medications Your pediatrician usually will suggest a medicated cream or ointment to control inflammation and itching. These preparations often contain a form of cortisone and should be used only under the direction of your doctor. In addition, other lotions or bath oils might be prescribed. It important to continue to apply the medications for as long as your pediatrician directs. Stopping too soon will cause the condition to recur. In addition to the skin preparations, your child may need to take an antihistamine by mouth to control the itching, and antibiotics if the skin becomes infected. The other type of eczema, contact dermatitis, is caused by contact with an irritating substance. One form of this condition results from repeated contact with irritating substances such as citrus juices, bubble baths, strong soaps, certain foods and medicines, and woolen or rough-weave fabrics. In addition, one of the most common irritants is the child own saliva. Contact dermatitis doesn itch as much as atopic dermatitis and usually will clear when the irritant is no longer present. Contact dermatitis can develop after skin contact with substances to which the child is allergic. The most common of these are: a.. Certain flavorings or additives to toothpastes and mouthwashes (these cause a rash around the mouth) b.. Glues and dyes used in the manufacture of shoes (they produce a reaction on the tops of the toes and feet) c.. Dyes used in clothing (these cause rashes in areas where the clothing rubs or where there is increased perspiration) d.. Nickel jewelry or snaps on jeans or pants e.. Plants, especially poison ivy, poison oak and poison sumac f.. Medications such as neomycin ointment This rash usually appears within several hours after contact (one to three days with poison ivy). It is somewhat itchy and may even have small blisters. The treatment of allergic contact dermatitis is similar to the treatment of eczema, although your pediatric dermatologist or allergist also will want to find the cause of the rash by taking a careful history or by conducting a series of patch tests. These tests are done by placing a small patch of a common irritant (allergen) against your child skin. If the skin reacts with redness and itching, that substance should be avoided. If your child appears to have a rash that looks like eczema, your pediatrician will need to examine it to make the correct diagnosis and prescribe the proper treatment. In some cases, the pediatrician may arrange for a pediatric dermatologist to examine your child. Alert your pediatrician if any of the following occurs: a.. Your child rash is severe and is not responding to home treatment b.. There is any evidence of fever or infection (such as blisters, redness, yellow crusts, pain or oozing of fluid) c.. The rash spreads or another rash develops http://www.aap.org/pubed/ZZZO4AUVQ7C.htm?&sub_cat=25. ============================================= Eczema / Atopic Dermatitis Background The worldwide prevalence of atopic dermatitis in children ranges from 2-30%.i. This wide variability is partly due to differences (and lack of consensus) in diagnostic criteria. One US study has reported the atopic dermatitis prevalence as 7-17% among school-aged childrenii, while European data suggests an adult point prevalence of 1-3%iii. Studies show that the persistence of atopic dermatitis is significant, so that adult lifetime prevalence is most likely much higher than the point prevalence data suggestsiv. Criteria to identify individuals with atopic dermatitis have been developed for clinical investigations and population-based studies. Based upon these criteria, validated screening tools with acceptable sensitivity and specificity (>80%) have successfully identified individuals with atopic dermatitis in the UK and USv,vi. Regrettably, these cumbersome screening tools were not designed to identify patients at risk for dermatological complications following vaccinia vaccination. The Israeli Defense force reported 1991-1996 improved screening strategies eliminated the occurrence of eczema vaccinatum from a rate of 0.15 in 10,000 in 1991-1995 to zero in 1996vii. Unfortunately, the methodology used to improve the dermatological screening strategies in the Israeli experience is unclear. A recent unpublished vaccine safety study revealed that 30-40% of patients with a validated diagnosis of atopic dermatitis and/or eczema failed to self identifyvii, which suggests a screening tool that relies solely on self reported data would miss a significant portion of at-risk individuals. The ability to reduce adverse events through improved screening strategies in conjunction with the unreliable self-reporting of contraindications ix,xxv,xvi, emphasizes the need for a simple yet accurate screening tool which can identify individuals who should avoid smallpox vaccination. Definitions: Eczema . This is a general term, generally synonymous with dermatitis, that is used loosely to define any red, scaly, itchy rash. This term does not discriminate between contact dermatitis, seborrheic dermatitis, atopic dermatitis, irritant dermatitis, nummular dermatitis, and a variety of other eczemas or dermatitides. The term "eczema" (Greek for "to effervesce" or "boil over") is very old, and was devised before our modern understanding of the distinct immunological and histopathological basis of different rashes. Often, at first evaluation, rashes can be difficult to precisely categorize, and in many instances, it is appropriate to denote red, itchy, scaly lesions as an "eczematous dermatitis". In the pediatric population, atopic dermatitis is the most common form of eczema, and as such is routinely referred to synonymously as "eczema," "infantile eczema," or "childhood eczema". In certain settings, such as the current smallpox vaccination effort, it is crucial to distinguish precisely the type of eczema. Decades ago, when smallpox vaccinations were administered routinely, it was known that active "eczema" or a past history of "eczema" was a risk factor for adverse vaccine events (particularly eczema vaccinatum). Today, we can link the vaccination’s risks more precisely to atopic dermatitis, by virtue of the immunological abnormalities associated with this disorder. Because rates of atopic dermatitis have increased significantly over the last 3 decades, it now becomes important to define precisely which types of eczema are true risk factors, and which are not. Indiscriminate exclusion of all forms of eczema might eliminate half of the population from receiving the smallpox vaccine, which would, in turn, hamper efforts to protect the population from smallpox bioterrorism. Atopic Dermatitis This is a specific term, describing a particular rash that is often red, scaly, and itchy. While there is no one objective marker for atopic dermatitis, we have a much more sophisticated understanding of this disease today than we did decades ago. It is now possible to define atopic dermatitis in terms of a constellation of findings. The most significant developments in understanding of atopic dermatitis lie in elucidating its immunology, and it is these immunologic aberrations that likely make these individuals vulnerable to severe side effects from vaccination. Nevertheless, as a practical screening tool, the natural history and clinical patterns of the rash are most pertinent to the screening efforts, and will be discussed herewith. Atopic dermatitis is most common among children, with a prevalence of 10-20% in pre-adolescents. The disease begins in infancy with most, with 50% affected by age 1 year, and 80% by age 5. Atopic dermatitis is characterized by episodes of exacerbation and remission. Exacerbating factors are numerous and include: anxiety, changes in temperature or humidity, irritants (perfumes, detergents, solvents), wool or other "scratchy" materials, perspiration, allergens (ingested, inhaled, contacted), and infections (particularly S. aureus). Atopics have hyperirritable skin, with the key symptom being pruritus (itchy skin). Scratching the skin leads to the clinical appearance of the skin. The skin findings in atopic dermatitis are usually distributed symmetrically, and often change location as the child gets older. Perhaps due to poorly developed motor skills involved in scratching, infants usually present with rash on the face, scalp, neck and extensor surfaces (rubbing affected parts against sheets/blankets). Toddlers and young children usually present with rash on the flexural surfaces of the arms and legs. In adults, atopic dermatitis is often localized to the hands (a subset of "hand dermatitis"), eyelids, or nipplesv. Acute skin changes are characterized by erythema, mild to moderate scale, small papules or vesicles, and excoriation marks. Secondary infection can cause further erythema and induce vesiculation, usually with yellow crusting. Chronic skin findings include lichenification (thickening of the skin with accentuation of skin lines and often hyperpigmentation) and excoriation marks. Atopic individuals often have concurrent dry skin, asthma, or environmental or food allergies. Most people with atopic dermatitis outgrow their disease with adulthood. Those who do not may have persistent rashes often just in selected body sites, such as the hands or eyelids. Even though the rash of atopic dermatitis may have resolved, the immunologic abnormalities that caused the disease seem to persist into adulthood and thereby the risk for adverse reactions to the smallpox vaccine continues. Screening Tool The following are highly suspicious of a diagnosis of atopic dermatitis: A recurring itchy red rash that lasts more than 2 weeks, plus: Rash involves the flexures OR Two of the following: Rash started before age 5 Personal history of allergies (food or environmental) or asthma First degree relative with atopic dermatitis Those with a current or past history of atopic dermatitis are excluded from vaccination with vaccinia. References: http://www.aad.org/professionals/educationcme/bioterrorism/EczemaAtopicDerma titis.htm ----- Original Message ----- From: "David Michael Gerungan" <[EMAIL PROTECTED]> To: <balita-anda@balita-anda.com> Sent: Monday, April 24, 2006 1:37 PM Subject: [balita-anda] Informasi mengenai Eksim Dear rekan-rekan BA, Mohon informasi dari rekan-rekan mengenai penyebab dan penanganan penyakit eksim pada anak balita. Terima kasih sebelumnya atas perhatiannya. David M. 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