This post is authored by Rima Sanka, D.O., a Tampa-based pediatric allergy, asthma and immunologist.  Dr. Sanka has published research about red tide, aeroallergies and primary immune deficiency, has served as a distinguished lecturer at several Florida conferences and has been featured on local news broadcasts.

Atopic Dermatitis or Eczema is characterized by itchy, dry, red, crusty or flaking skin.  In more serious cases, skin may also blister, crack, ooze or bleed.  Most people think that it’s just a skin problem.  But in kids, it could mean something more.  The majority of children with eczema have allergic eczema driven by allergies to foods or to their environment.   If your child has eczema, he or she may benefit from allergy testing and treatment. 

Eczema is particularly noticeable on the face, scalp, neck, insides of elbows, behind knees and on the buttocks.  Eczema has a hereditary component and often occurs in families with hay fever and asthma.  The incidence of allergic eczema is rising rapidly, especially in developed countries.

Identifying eczema is important because it is often the first manifestation of the “allergic march,” which, if left unchecked, could possibly lead to hay fever and asthma.  To determine whether eczema is the result of an allergen, your allergist may recommend skin testing.   A tiny amount of the suspected allergen is placed onto the skin (or alternatively into a testing device that pricks the top layer of skin), thereby exposing the skin to a small amount of the allergen.  This test generally yields a positive or negative result.  If a person is allergic, a hive or wheal will form at the testing spot.  Skin testing is a precise and reliable test for IgE antibodies to specific substances, and is useful for quickly learning whether or not a person is allergic to a particular food. 

In addition to skin testing, your allergist may also order a blood test for the levels of antibodies and the numbers of certain types of cells.  In eczema, the blood may show an increased number of IgE antibodies or eosinophils.  Both tests are valuable tools in making the diagnoses of allergy, prescribing treatment, and predicting disease development.

Occasionally, the diagnosis may also involve a skin biopsy – a procedure that removes a small piece of the affected skin which is sent to a pathology laboratory for microscopic examination.

Skin tests, blood tests and biopsies are not always necessary for eczema diagnosis.  However, doctors may require them in order to identify particular triggers.

Treatment for eczema includes removal of allergens first and foremost.   This means that identifying allergies is key.  Other acceptable treatments include moisturization, gentle cleansers, itch relief medication, environmental and behavioral modification, corticosteroids, antibiotics, immunomodulators, immunosuppressants, light therapy, and alternative therapies.  Most patient will outgrow their eczema by 5 years of age.

What else can you do?  Studies suggest that delaying the introduction of solid foods until 4-6 months of age and breastfeeding for at least 3 months may decrease or delay one’s chance of developing eczema.  Current research is looking into herbal and skin cell growth factors as new treatment approaches for recalcitrant eczema.

© 2010 Rima Sanka, D.O.

Image by National Eczema Association

The advice and contents of this blog post are for general informational purposes only and are not intended to constitute any expert or professional opinion.  Nothing contained herein is intended to create a physician-patient relationship.  You are advised to consult with a medical professional.


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