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Dermatitis


What is dermatitis?

Dermatitis (from Greek derma, dermat- ‘skin’ + -itis. Inflammation) is a condition of the skin in which it becomes red, swollen, and sore, sometimes with small blisters, resulting from direct irritation of the skin by an external agent or an allergic reaction to it. Most types of dermatitis are characterized by an itchy pink or red rash.

Various types of dermatitis

Different kinds of dermatitis are linked by the common allergic reaction to specific allergens. Eczema is also a kind of dermatitis, called eczematous dermatitis. An eczema diagnosis often implies atopic dermatitis (very common in children and teenagers) but, without proper context, may refer to any kind of dermatitis. Often dermatitis is differentiated from eczema, the former depends on some external irritant whereas the latter typically has no obvious external cause. However, Dermatitis and eczema may sometimes be used synonymously and often classified together.

  • Atopic dermatitis is characterized by itching, scaling, swelling, and sometimes blistering. In early childhood it is called infantile eczema and is characterized by redness, oozing, and crusting. It is usually found on the face, inside the elbows, and behind the knees. Atopic dermatitis can be caused by allergies, asthma, or stress, and there seems to be a genetic predisposition for atopic conditions. It is sometimes caused by an allergy to nickel in jewellery.
  • Seborrheic dermatitis may be dry or moist and is characterized by greasy scales and yellowish crusts on the scalp, eyelids, face, external surfaces of the ears, underarms, breasts, and groin. In infants it is called "cradle cap." Seborrheic dermatitis (for which there may also be a genetic predisposition) is usually caused by overproduction of the oil glands. In adults it can be associated with diabetes mellitus or gold allergy. In infants and adults it may be caused by a biotin deficiency.
  • Contact dermatitis can occur on any part of the body, but it usually affects the hands, feet, and groin. Contact dermatitis usually does not spread from one person to another, nor does it spread beyond the area exposed to the irritant unless affected skin comes into contact with another part of the body. It is an allergic reaction to something that irritates the skin and is manifested by one or more lines of red, swollen, blistered skin that may itch or seep. It usually appears within 48 hours after touching or brushing against a substance to which the skin is sensitive. The condition is more common in adults than in children. Contact dermatitis can develop when the first contact occurs or after years of use or exposure.
  • Stasis dermatitis is characterized by scaly, greasy looking skin on the lower legs and around the ankles. Stasis dermatitis is most apt to affect the inner side of the calf.
  • Nummular dermatitis, which is also called nummular eczematous dermatitis or nummular eczema, generally affects the hands, arms, legs, and buttocks of men and women older than 55 years of age. This stubborn inflamed rash forms circular, sometimes itchy, patches and is characterized by flares and periods of inactivity. The cause of nummular dermatitis is not known, but it usually occurs in cold weather and is most common in people who have dry skin. Hot weather, stress, allergens, soaps, detergents etc. can aggravate this condition.

The various causes and modifiers of dermatitis include the following:

A number of health conditions, allergies, genetic factors and irritants can be responsible for causing dermatitis. There are several types of dermatitis which are distinguished based on the factor that triggers the skin reaction. The common modifiers include-

  • Various genetic and environmental factors
  • Soaps and detergents
  • Rubber, metal, jewellery, cosmetics, perfumes etc.
  • Dry skin, chronic irritation, eczema and psoriasis
  • Burns and sunburn
  • chemical irritants like chlorine, detergents, perfumes
  • hot weather
  • stress
  • allergies

What are the manifestations?

  • Itching (pruritus) of the skin in exposed areas
  • Skin redness or inflammation in the exposed area
  • Tenderness of the skin in the exposed area
  • Localized swelling of the skin
  • Warmth of the exposed area (may occur)
  • Skin lesion or rash at the site of exposure
    • Lesions of any type: redness, rash, papules (pimple-like), vesicles, and bullae (blisters)
    • May involve oozing, draining, or crusting
    • May become scaly, raw, or thickened

Diagnostic procedures

The diagnosis is primarily based on the skin appearance and a history of exposure to an irritant or an allergen. According to the American Academy of Allergy, Asthma, and Immunology, "patch testing is the gold standard for contact allergen identification." Allergy testing with skin patches may isolate the suspected allergen that is causing the reaction.

Patch testing is used for patients who have chronic, recurring contact dermatitis. Other tests may be used to rule out other possible causes, including skin lesion biopsy or culture of the skin lesion.

A diagnosis is usually made on clinical grounds. Histopathological findings are non-specific, thus making tissue biopsies unhelpful except in cases where the intent is to exclude psoriasis. There are no laboratory markers to support this diagnosis.

Conventional Treatment

The primary treatment involves prevention, includes avoiding or minimizing contact with (or intake of) known allergens. Once that has been established, topical treatments can be used. Topical treatments focus on reducing both the dryness and inflammation of the skin.

Topical corticosteroid ointments, creams, or injections. Corticosteroids have traditionally been considered the most effective method of treating severe eczema. Disadvantages of using steroid creams include stretch marks and thinning of the skin. Higher-potency steroid creams must not be used on the face or other areas where the skin is naturally thin; usually a lower-potency steroid is prescribed for sensitive areas.

If complications include infections (often of Staphylococcus aureus), antibiotics may be employed. However, all these treatment modalities are short acting, and don’t give long term relief. The dependence of the patient on these therapies increases with the continuation of treatment. The side effects and other worsening factors add to the dilemma.

Why homoeopathy?

Our body is unity of all the organs and their collective functioning, whether it be skin, kidney, lungs, or brain. They are linked to each other. A disorder in any part is apt to manifest at some other place. Homoeopathy directs its treatment process towards the underlying vital operations. It treats the whole patient by analyzing all the symptoms pertinent to the person.

Skin is called the watchman of the body, because it covers the vital parts of the organism and gives them security. So its derangement can occur only when internal homoeostasis is disturbed by inimical influences. The treatment of skin disorders, therefore, doesn’t depend on external applications, rather it needs a radical approach that will cure the roots of the disease process. Homeopathy has the power and capability to achieve just that.

Homeopathy is known worldwide to be the best treatment option for skin disorders. It not only provides good symptoms control, but also prevents relapses, strengthens the immune system and achieves a permanent cure.