Eczema (atopic dermatitis) Quiz

True. Eczema usually starts in the first few years of life. It may persist beyond childhood into adolescence and adulthood. Dermatitis that starts in adulthood is more likely to be contact reactions to chemicals in medicines, jewelry or make-up. However, adult onset of eczema is also seen.

False. Eczema normally affects areas that are exposed. In young babies it commonly affects the face. In children it commonly affects the wrists, ankles, fronts of the elbows and backs of the knees. In adults, eczema is often most troublesome on the hands. Eczema rarely affects the groin, and other causes should be considered if rash affects this area of the body. Eczema may appear differently in different races/ethnicities.

True. Leaky skin, particularly in early childhood, is believed to allow irritants through and cause the itch and redness. However, this may not be responsible for all causes of eczema.

True. If neither parent has eczema the risk to the child is one in 10. If one parent is affected the risk is 50% and it increases to 70% if both parents have a history of eczema. In some patients with relatives from the United States, Northern Europe and the Far East, eczema is inherited because of a faulty skin gene called filaggrin.

False. These allergy tests may support the diagnosis of allergies where there is an immediate reaction leading to hives or swellings. However, they are more likely to produce false results if used to investigate what may be causing eczema flares. Inappropriate use of these tests in eczema patients often leads to unnecessary restrictions in a patient’s diet and lifestyle and may actually promote the development of new allergies.

False. Foods rarely cause eczema flares in school-age children and adults. They may cause flares in young infants and pre-school children. The most common foods triggering eczema in young children are dairy, soy, wheat and eggs. Peanuts, tree nuts and fish tend to cause hives and skin swellings rather than eczema flares. Many children outgrow their allergies to dairy, soy, wheat, and egg. Foods should not be taken out of a child’s diet without first obtaining advice from a healthcare professional. They can also provide advice as to when foods might be reintroduced back into the child’s diet.

True. Moisturizers, particularly oil-based moisturizers promote a better barrier and keep the skin moist. Creams are less effective and the chemicals in some creams may cause irritation. The choice of moisturizer is best left to the patient and their family, as personal preference ensures that the patient is happy with the medicine and will use it regularly.

False. Topical steroids come in different strengths. One percent hydrocortisone is a mild potency steroid, which can be used regularly twice a day on inflamed skin without a significant risk of skin thinning or other side effects. More potent steroids should be used for up to a week or two unless otherwise directed by your healthcare professional. Potent steroids should not be applied to the face and neck because of the risk of skin damage in these more delicate areas of the body.

False. Although antihistamines may be helpful for allergic reactions causing hives and superficial swellings, they do not reduce the itch of eczema.

False. Crusty, oozing, painful skin suggests a bacterial infection of the skin. It is not because the patient has suddenly become immune to the eczema treatment. The infection may have been caused by scratching, allowing bacteria to take hold. See your doctor for re-evaluation as antibiotics may be required. Keep your nails short to avoid future skin damage when scratching.