Q. MY YOUNG child has been diagnosed as having infantile eczema. Could you explain what this disease is and how it is treated. Can it be prevented from recurring?
A. This is one of a group of inherited predispositions which also includes hay fever, seasonally allergic noses, asthma and urticaria. Suspected factors may include certain foods such as eggs, cows' milk, wool and house dust.
Infantile eczema usually starts after three months of age. The rash usually appears first on the forehead and cheeks, and spreads to involve the backs of the hands, ankles, feet and limbs. The scalp may also be involved. The infant or child is irritable and continually scratching, causing weeping of the lesions with crusting and secondary infection. The eruption gradually changes to a scaly dermatitis, and by the age of three years, it largely involves the inner aspect of the elbows, the backs of the knees, face and neck.
If you think the infant may be sensitive to anything in its diet, withdraw it. The withdrawal of all milk as a therapeutic test may be worth trying and also reduction of the fat content of the diet. Mild detergents rather than soap are preferable in cleaning the skin.
Treatment depends on whether the eruption is in the weeping or dry and scaly stage. In the weeping stage, various lotions can be applied. In the dry stage, hydro cortisone ointments or creams are applied, sometimes combined with antibiotics if there is secondary infection present.
Approximately 50 percent of cases resolve by the age of two years. The remainder develop a chronic dermatitis which fluctuates for many years and may be associated with other inherited predispositions such as asthma.
Q. Is there a simple way of getting rid of the skin irritation that goes with varicose veins, specially around the ankles?
A. This is called varicose eczema. It is aggravated by the accumulation of fluid occurring in these areas. This must be reduced. Using elasticized stockings; elevating the feet whenever possible: crepe bandages (can be worn under slacks) are all effective methods. Sometimes creams (prescribed by a doctor) assist.