Eczema, also known as atopic dermatitis, is a common chronic skin condition that can lead to recurrent infections and poor quality of life if left untreated. This activity reviews the evaluation and management of eczema and highlights the role of interprofessional teams in improving outcomes for patients with this condition.
Objectives:
Review the pathophysiology of eczema.
Outline the adverse effects of poorly controlled eczema.
Summarize the treatment options for eczema.
Describe the importance of improving care coordination amongst the interprofessional team to improve outcomes for patients with eczema.
Eczema, also known as atopic dermatitis, is the most common form of dermatitis. Genetic as well as environmental factors are thought to play a part in the pathogenesis. Eczema is most commonly seen in children but can be seen in adults. People with the disease tend to have dry, itchy skin that is prone to infection. Eczema is commonly known as the “itch that rashes” due to dry skin that leads to a rash as a result of scratching or rubbing. The most important treatment of eczema is skin hydration followed by topical steroids for flare-ups.
Etiology
People with eczema have a dysfunctional barrier which causes various problems. The cells that make up our skin are essential for optimal skin hydration. People with eczema tend to have dry skin due to the dysfunction in the skin barrier. Water can more easily escape from the skin leading to dehydrated skin. People with eczema are also more susceptible to infection. Harmful substances can more readily penetrate the skin due to the dysfunction. People with atopic dermatitis tend to have a skewed inflammatory immune response, and their skin is easily irritated by fragrances and allergens.
Epidemiology
The lifetime prevalence of atopic dermatitis is about 15-30% in children and 2-10% in adults. About 60% of cases will develop within the first year of life. The prevalence of atopic dermatitis is more common in rural rather than urban areas. This incidence which emphasizes the link to lifestyle and environment factors in the mechanisms of AD. Atopic dermatitis is apart of the triad known as the ‘Atopic march.’ This relates to the association between patients with atopic dermatitis, asthma, and allergic rhinitis. About 50% of patients with severe atopic dermatitis will develop asthma, and 75% will develop allergic rhinitis.[1]
Pathophysiology
Research shows there is a genetic component to atopic dermatitis. One common mutation has been observed in the gene Filaggrin, a vital gene for skin cell maturity. This gene is responsible for creating the tough, flat corneocytes that form the outermost protective layer of skin. In a patient with normal skin cells, the corneocytes are tightly packed in an organized manner. A patient with a filaggrin mutation will have a dysfunctional skin barrier due to the haphazard organization of the skin cells.[2] This dysfunction causes a ‘leaky’ skin barrier allowing water loss and decreased protection from harmful substances. People with eczema also have reduced numbers of beta-defensins in the skin. Beta-defensins are host defense peptides that are vital for fighting off certain bacteria, viruses, and fungi. A decrease in these peptides leads to increased colonization and infection, especially with staph aureus.[3]
Histopathology
The histopathology seen in atopic dermatitis is non-specific. In the acute phase lesions, characterized by intensely pruritic, erythematous papules, histopathology reveals mild epidermal hyperplasia, infiltrations of lymphocytes and macrophages along the venous plexus in the dermis and intercellular edema of the epidermis (spongiosis). Lesions biopsied in chronic atopic dermatitis, which are characterized by lichenification and fibrotic papules, may reveal increased hyperplasia and hyperkeratosis of the skin. There is also persistent dermal inflammatory cell infiltrate with lymphocytes and macrophages. The chronic phase lacks the edema or spongiosis that is present in acute phase lesions.
History and Physical
Acutely the rash will be intensely pruritic with erythematous papules and excoriations. As the person continues to itch and rub the skin, the skin starts to thicken and on physical exam, there may be lichenification (thickening of the skin with exaggeration of the typical skin markings due to scratching or rubbing).
The distribution of the rash seen in atopic dermatitis will vary depending on the age of the person. Infants tend to have widely distributed, dry, scaly and erythematous patches with small excoriations. They also tend to have involvement of their face, especially the cheeks. As the child ages, the rash becomes more localized. Areas affected will include the extensors surfaces such as the wrists, elbows, ankles, and knees. School-aged children tend to follow the pattern that is seen in adults. This pattern includes the involvement of the flexural surfaces usually affecting the anti-cubital and popliteal fosse.
Other physical exam findings besides the appearance of a rash may indicate a person has eczema. Examination of the face may reveal Dennie-Morgan lines. These are crease-like wrinkles just below the lower eyelid. This exam finding can be seen in up to 25% of patients with eczema. People with eczema may have co-existing pityriasis alba and have hypopigmented patches or fine scaling plaques more commonly seen on the face. On examination of the hands, there may be an increased number and depth of skin lines known as hyperlinear palms. People that have eczema and allergic rhinitis may have a transverse crease formed across their nose. This line is referred to as the “allergic salute” and is caused by habitually rubbing the nose in an upward manner.[4]
Evaluation
Diagnosis is typically clinical based on the appearance of the rash and history. Routine labwork is not usually indicated. If unsure of the diagnosis, allergy testing and patch testing may be performed.
Treatment / Management
The main management and treatment of atopic dermatitis include hydration and topical anti-inflammatory medications for flare-ups. The priority in treatment is focusing on a daily skin moisturizing regimen with a fragrance-free ointment that has limited preservatives.[5] An ointment is preferred over a cream due to the high proportion of oil to water in lotions. Patients/parents should also identify and address any triggers. They should be instructed to avoid any environmental allergens, harsh soaps, and detergents, fragrances as well as rough…
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Summer is a cheerful holiday season, but no one likes the harsh sun.
Exposure to the sun not only tans the skin but also causes skin problems like dark spots and hyperpigmentation. Harmful UV radiation strips the skin of its moisture content and eventually makes it appear pale and dull.
Are you worried about stepping out in the sun during summers? Then, fret not! Ayurveda has a solution to everything, and tanning is no exception.
How to remove tan naturally?
Ancient Ayurveda texts claim Turmeric, Saffron, Sugar, and nut-based oils to be excellent healers of skin tanning. In this article, we’ll talk about simple tan removal home remedies that you can use to remove tan from your body.
Whether you are suffering from the tan due to strolling around the city or relaxing at a beach destination for days together, these natural home remedies will help in sun tan removal.
You can use them to remove sun tan from all over your body – be it your neck, your feet, your arms or your hands.
1. Lemon Juice And Honey To Remove Tan
How to apply –
Squeeze fresh lemon juice and add some honey to it. Apply the mixture on your skin and let it stay for 30 minutes before washing off with a mild cleanser.
You can also add some sugar to the lemon juice to make a scrub. In addition to removing tan, this will also slough off dead cells from the surface.
Why it works –
Lemon juice has a bleaching effect, which helps in removing tan quickly. It contains Vitamin C in abundance, which is a great tan removal agent. The citric acid present in lemon helps in the removal of acne and lightening of the marks.
Pro tip –
Do not allow the honey to remain on your skin for too long if you have an oily face. You can even try applying lemon directly without honey.
2. Coconut Milk For Natural De Tan Treatment
How to apply –
Soak a cotton ball in fresh and organic coconut milk and dab it all over the face. Leave it on till it’s absorbed into the skin or dries completely. Wash it off with a mild cleanser.
Why it works –
Coconut milk is highly nourishing and hydrating for the skin. It helps in restoring the lost moisture. The vitamin C and the mild acids present in it help in tan removal at home.
Pro tip –
Apart from applying coconut milk, you can also use de-tanning treatments with coconut milk as the base. Kama Ayurveda’s Jwalini Retexturizing Skin Treatment Oil is one such treatment. Prescribed in Ayurveda as a treatment for smooth, soft and clear skin, this oil treatment is formulated from natural herbs processed in pure Coconut milk and Sesame oil.
3. Oatmeal And Buttermilk For Tan Removal
How to apply –
Soak 2 teaspoons of oats or oatmeal in half a cup of water for about five minutes. Add 2-3 teaspoon of fresh, plain buttermilk to it and mix well. You can add honey as well to make the pack more moisturizing. Mix these ingredients well to form a paste and then apply it to your face, neck, arms and other areas affected by tanning.
Rub in a circular motion and let it stay for about 20 minutes. Wash off with reveal fresh, brighter looking skin.
Why it works –
Oatmeal has excellent exfoliating and skin cleansing properties. Buttermilk is rich in lactic acid which removes tan, softens the skin and improves skin tone.
Pro tip –
Oatmeal is also a key ingredient of the traditional Ayurvedic recipe for Ubtan. Kama Ayurveda’s Ubtan is a powdered mix of Ayurvedic herbs and natural ingredients. It can be used as a soap-free natural cleanser to remove tan from the body.
The home remedies mentioned above are useful for removing tan from all over the body. However, if you want to remove tan from face, then the following home remedies and de tan treatments will be useful.
How To Remove Tan From Face?
Saffron, Sandalwood, Turmeric and Multani Mitti are some miracle ingredients when it comes to sun tan removal from face. Here are a few ways you can use them to get a glowing skin.
4. Massage with Ayurvedic De Tanning Oil – Nalpamaradi Thailam
How to apply –
Post cleaning your face and body, pour some oil on your palm. Start with gently massaging your face in a circular motion until fully absorbed. Then, gently massage the oil all over your body in brisk upward and downward strokes until fully absorbed.
Why it works –
The oil has the leaves and the bark of the sacred Peepal tree as one of the key ingredients. A rich source of vitamin K, the bark of a Peepal tree is an excellent solution for removing skin tan. It not only strengthens blood capillaries and minimises skin inflammation but also heals skin bruises faster by increasing skin resilience.
Pro Tip – Described as a natural skin illuminator in Ayurveda, Nalpamaradi Thailam is a miracle oil that lightens the complexion and removes tan without causing any harm to the skin. This makes it one of the best natural products for bridal skin care. Start getting regular massages with this oil one year before the wedding if tanning is a major skin concern for you.
Saffron, Sandalwood, Turmeric and Multani Mitti are some miracle ingredients when it comes to sun tan removal from face. Here are a few ways you can use them to get a glowing…
Hard gestudeerd of gewerkt? Vergeet niet om te ontspannen op gezette tijden! De geest heeft ontspanning nodig om weer ruimte te maken voor nieuwe dingen en bovendien werkt het stress-verlagend. Ga lekker sporten, lees een boek of ga met verstand op nul Netflixen. Of stap in bad met een lekker badproduct. Er zijn verschillende badproducten die zo zijn ontwikkeld dat ze een ontspannende werking kunnen hebben. Lekker relaxen wordt zo nog makkelijker!
Therme Skincare
Therme Skincare combineert de rijke inspiratie van de natuur met de meest nieuwe, wetenschappelijk inzichten. Dit leidt tot hoogwaardige producten, waarmee iedereen zichzelf optimaal kan verzorgen, verwennen en professioneel kan kuren in de oase van de eigen badkamer. De producten van Therme Skincare zijn verdeeld in de volgende drie categorieën: Therme Wereldkuren, Therme Face Care en Therme Anti-transpirant. Verwen uzelf met de heerlijke producten van Therme Skincare. De producten van Therme zijn een genot voor de zintuigen en geven u de ultieme wellness beleving. Bij Therme heeft men de natuur en schoonheidsrituelen als inspiratiebron genomen en zodoende tot 14 geurlijnen ontwikkeld, de zogenaamde Therme Wereldkuren.
Therme Wereldkuren
Met de producten van Therme Wereldkuren kunt u genieten van een spa- en wellness behandeling vanuit uw eigen badkamer. De uitgebreide collectie bestaat uit wel 14 geurlijnen die heerlijke body- en beauty producten bevatten. Denk bijvoorbeeld aan ontspannende douchecrèmes, heerlijke bodyscrubs, verzorgende bodybutters en geurende bodymists. Bij De Online Drogist vind u de volgende Therme Wereldkuren in het assortiment:
Therme Ayurveda
Therme Ayurveda bevat mysterieuze, kruidige en lichtzoete aroma’s van sinaasappel, patchouli en sandelhout. Stimuleer geestelijke en lichamelijke ontspanning met deze spirituele bad & body kuurproducten.
Therme Bali Flower
Bali Flower van Therme zijn Oriëntaalse verzorgingsproducten met een vleugje vanille, orchidee en jasmijn. Geniet van de natuurlijke bronnen zoals bloemen, kruiden, rijst en oliën uit de Balinese binnenlanden, die de basis vormen voor deze verzorgingslijn.
Therme Bulgarian Rose
De Therme Bulgarian Rose producten hebben een betoverende en elegante rozengeur met zeer milde huidverzorgende eigenschappen. Verrijkt met roos- en cranberryextracten die een intensief verzorgende en kalmerende werking op de (droge) huid hebben.
Therme Finn Sauna
Met de Therme Finn Sauna producten kunt u een ontspannend spa- en sauna moment eenvoudig thuis beleven. Etherische geuren als Eucalyptus, Menthol, Dennen en Lavendel, ontspannen en verkwikken lichaam en geest. Ook aan te raden bij verkoudheid, na het sporten of intens verfrissend tijdens de warme zomermaanden.
Therme Hammam
Verhef baden tot een kunst met het eeuwenoud traditioneel reinigingsritueel, dat fijn is voor zowel lichaam als geest. De Therme Hammam-producten zijn fris en zoet en bevatten Cederhout, pure Olijfolie en Oosterse kruiden.
Therme Japanese Sento
Therme Japanese Sento is geïnspireerd op de geheimzinnige beauty ceremonie van de Japanse Geisha’s, de Japanse badhuisrituelen van de Sento. Met de delicate geur van magnolia en kersenbloesem.
Therme Lomi Lomi
Therme Lomi Lomi is gebaseerd op de Hawaiiaanse ‘Lomi Lomi massage’ gecombineerd met de oase van Tahiti vol met prachtige bloemen, vruchten en heerlijke geuren. De basis van deze geurlijn is kokosnoot en de frangipanibloesem. Ervaar de onvergetelijke paradijselijke wellnessbeleving bij u thuis!
Therme Marrakesh
Therme Marrakesh is de ultieme verwennerij dankzij haar kostbare en verzorgende arganolie en amandelolie. Deze oliën zijn intens voedend voor de droge huid.
Therme Provence Lavender
Lavendel staat bekend om zijn ontspannende werking voor lichaam en geest. De Therme Provence Lavender producten beschermen, herstellen en verzorgen de (extra) droge huid dankzij Honing, Royal Jelly, Zonnebloem, Sheabutter en Lavendel. Een ultra zacht en glanzende huid zijn het resultaat.
Therme Saigon Pink Lotus
De producten van de Therme Saigon Pink Lotus Wereldkuur hebben hun luxueuze geur te danken aan de aroma’s van roze lotus, amber, vanille en sandelhout. De amber- en lotusextracten zorgen voor een intensieve voeding van de huid met een zijdezachte huid als resultaat.
Therme Thai Jasmine
Therme Thai Jasmine bevat etherische Jasmijnolie, een prachtige bloem met een verleidelijke geur. Daarnaast bevat deze lijn ook neroli en bergamot die direct zorgen voor een opgewekt humeur en een ultravrouwelijk gevoel.
Therme Thalasso
Therme Thalasso is gebaseerd op de Atlantische oceaan en de Dode Zee, vanwege zijn rijke bronnen van mineralen en zeealgen. Deze mineralen en zeealgen vitaliseren de huid en zijn verfrissend voor lichaam en geest.
Therme Ylang Ylang
Ervaar een exotische geurbeleving met Therme Ylang Ylang. Dit is een exotische bloem met een weelderige, sensuele geur die een ontspannende en harmoniserende invloed heeft op alle zintuigen.
Therme Zen White Lotus
Zen is de Japanse vorm van boeddhisme en staat tevens voor het creëren van innerlijke rust. Therme Zen White Lotus bevat Witte Lotus, die symbool staat voor geestelijke zuiverheid, puurheid en zachtheid.
Therme deodorant
Therme biedt een ruime keuze aan deodorant producten, die voor elk transpiratieprobleem een effectieve oplossing biedt. De anti-transpirant van Therme zijn bijzonder milde en huidvriendelijke producten die geen kleurstoffen, conserveermiddelen of andere irriterende stoffen bevatten.
Therme Anti-transpirant bevat stoffen die het aanmaken van zweet afremmen. Indien u veel transpireert is een anti-transpirant van Therme een goede keuze.
Wat Therme anti-transpirant producten zo uniek maakt is dat ze het “Sensitive System” bevatten, dat een drievoudige werking heeft:
Het werkt in op bacteriën die de transpiratiegeur veroorzaken. De overige huidflora wordt niet aangetast, waardoor irritaties van de okselhuid vermeden worden;
De anti-transpirant vermindert op een natuurlijke wijze vochtvorming, waardoor de huid langdurig fris en droog aanvoelt;
De subtiele geurbeleving is fris en harmonieert altijd met iemands persoonlijke parfum.
Naast Therme Anti-transpirant heeft De Online Drogist ook Therme deodorant in het assortiment. Verkrijgbaar in heerlijke geuren, voor een fris gevoel, zonder witte strepen in uw kleding achter te laten.
Therme Face Care
Tot slot mogen we niet de gezichtsverzorgingsproducten van Therme vergeten. Wist u al dat Therme ook heerlijke maskers en een face scrub in het assortiment heeft? Therme Soft Face Peeling is een zachte scrub met een zee-algencomplex dat zorgt voor een stralend en frisse huid.
De 3-minuten maskers van Therme Face Care zijn ideaal wanneer u uw huid even een oppepper wilt geven, maar weinig tijd heeft. De 3-minuten maskers bevatten natuurlijke extracten die verzorgend zijn voor uw huid en tegelijkertijd uw huid weer in balans brengt. U kunt deze maskers gewoon onder de douche gebruiken, en zeker in combinatie met de Therme Soft Face Peeling ervaart u een mooie, zachte…
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An all-natural deep conditing hair treatment, this formula repairs damage, slows fallout, and conditions locks for thicker volume and shiny, silky texture.
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Smooth away uneven skin tone with this targeted spot treatment to diminish signs of hyperpigmentation and under eye circles.
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