Dr. Robert Salmon
25 Osborne Street
WOLLONGONG NSW 2500
Ph 02 4226 3088
Fax 02 4227 1606
mail@idlc.com.au
eczema / Dermatitis
These two terms describe exactly the same condition and can be used interchangeably. The term eczema is used here. It can be genetically based (endogenous) or caused by the environment (exogenous), or frequently a mix of the two.
Atopic eczema is the main genetically based form, and can be associated with asthma and hayfever. It can affect patients from age 4 weeks (infantile eczema) to the elderly. People with this condition have skin that is more easily damaged than normal, and general measures such as avoiding standard soaps and using moisturisers are an important part of the treatment program. Wise use of steroid creams still forms the basis of treatment in mild cases. Pimecrolimus, a drug used in organ transplant patients, is now available in cream form for facial eczema. For severe and extensive cases, narrow band UVB therapy (phototherapy) can be helpful (see Psoriasis). Cyclosporin A, a drug used in organ transplant patients is also used in severe cases.
Exogenous eczema can be either allergic or irritant, or a combination of both. The treatment of allergic eczema is based on finding the allergen that is coming into contact with the skin and avoiding it. Patch testing, a service available at ID+LC, can be of help with this. Contact irritant eczema is seen most frequently on the hands, and may be caused by constant contact with water, soaps and in a community such as the Illawarra, where there is a good deal of heavy engineering, contact with such substances as cutting oils and diesel can be the cause. Avoiding the irritant, in combination with moisturisers and steroid creams, is the standard treatment.