Health and Medicine: Eczema & Psoriasis

ECZEMA AND PSORIASIS
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ECZEMA AND PSORIASIS
Introduction
Skin disorders often cause a lot of discomfort. It, therefore, calls for thorough diagnosing of the skin diseases such as psoriasis and eczema for treatment on time. These two skin disorders may appear similar but they are different. In most cases it is difficult to distinguish one from the other. Moreover, their symptoms are almost alike. Eczema at times is referred to as the dermatitis. There are various types of eczema with the most common one being atopic dermatitis. Eczema is a group comprising conditions on the skin such as hotness, dryness, scaly and itching. In cases where the condition is severe, the skin may be raw and bleeding. This disorder is caused by the exposure of the skin to the environmental allergies and or irritants (Moscou, K & Snipe, 2009).
The symptoms of the disease are worsened by conditions such as hormonal fluctuations and stress. On the other hand, psoriasis is an inflammatory skin disorder. The most common type of the disorder is the plaque psoriasis that appears around the knees, elbows, lower back and scalp. Psoriasis is commonly marked by raised red patches on the skin that are covered with a silvery layer. In general, eczema caused by the exposure of the body into environmental factors such as harsh chemicals in the environment and psoriasis is mainly caused by genes and responds to internal factors (Moscou, K & Snipe, 2009).
The paper focuses on eczema and psoriasis as the skin disorders. Emphasis is put on the causes, signs and symptoms of the disorders, the possible treatments and their adverse effects on the patients and the role of the pharmacy technician (Terrass, 1995).
ECZEMA
Description
Eczema is the most common skin disorder (inflammation). It refers to various conditions that have a common pattern of changes on skin`s surface. It initially appears as an episode of itching scratching and redness in the skin which may be accompanied by small blisters and or bumps. If the condition grows into chronic eczema (long term eczema) it may result into scaling, thickening of the skin, dryness, flaking and change in skin color. Eczema has various types that depend on the shape, location, cause and size of the rash. Most of the eczema types are linked to being allergic to chemicals and irritants. Still others are related to underlying medical conditions that may cause fluid retention in the legs. Approximately, fifteen percent of the world`s population is affected with eczema. The following are various types of eczema and their possible causes (Moscou, K & Snipe, 2009).
Atopic (dermatitis) eczema is one of the most common types of eczema (Terrass, 1995). This type is characterized by a repeated appearance and disappearance. It is common in people who have a tendency of genetic allergies. In all the cases of atopic eczema, about seventy percent of the patients, the person affected or a family member has allergic reactions to asthma, foods and hay fever. The disorder affects mostly babies between two to eighteen months of age where it appears around the neck, torso and ears. On older babies as well as adults it commonly appears on elbows, ankles and knees.
The other type is the contact dermatitis (Terrass, 1995). There are two kinds of contact dermatitis. The first one is the irritant contact where the skin is exposed to the irritants. Prolonged contact of the skin with irritant such as soap, sweat, saliva, urine and bubble bath among others are likely to cause contact dermatitis. The other kind is the allergic contact dermatitis. This allergic reaction takes place on the skin to some substances. Therefore, this only happens to those individuals who are allergic to some substances and it does not have to be a prolonged contact with the skin. Some of the substances with the antigens that may cause allergic contact dermatitis include poison oak, cleaning products, deodorants, medications, cosmetics and building materials used to build offices and homes. Further, chemicals used in manufacturing clothes, body lotions, fragrances and clothing may cause allergic contact dermatitis.
Hand eczema is another type of eczema skin disorder. This type may be limited to hands and may be caused by the use of some strong detergents when washing and or because of repeated hand washing activities. It can be related to atopic eczema and in most cases it may be caused by allergy to some substances such as latex.
Nummular eczema is another skin disorder in the category of eczema. This type causes patches at the size of coins that irritate the skin. They mostly appear on arms, legs, and chest. In most cases, nummular eczema represents an allergic reaction to fungal infections such as the athlete`s foot. It is notable that though the infection may be on other parts of the body, the skin irritations will still appear on chest, arms and legs. Finally, there is Lichen simplex chronicus. This disorder is caused by repeated rubbing or scratching of the skin on one location. Nervous scratching of the skin may cause thickened and discolored skin on the ankle, wrist, and groin and or back of the neck.
Signs and symptoms
As mentioned above, eczema may show up through various signs as well as symptoms. However, these may vary from one type of eczema to another. Some signs may show in one type of eczema while some may not. For example the hand eczema may vary from atopic dermatitis in a number of ways. There, it may be difficult for the patients to distinguish one from the other. This would call for the patient to see a physician. Generally, the symptoms of eczema include itchy skin, tinny blisters as well as bumps, and redness of the skin. In case these symptoms are not treated in time they might develop into a thickened skin, scaly, color changes and loss of hair. If a patient is affected by long-term eczema, they become vulnerable to secondary infections caused by bacteria. In every type of eczema, there are specific signs as well as symptoms as discussed below (Moscou, K & Snipe, 2009).
Atopic dermatitis also known as atopic eczema appears as irritated, dry, crusted, and red patches on the skin. At times when the skin is infected it develops a weeping (wet) appearance. This may cause the feeling to scratch the patches. However, if the patches are scratched they may cause an infection by the bacteria.
Contact dermatitis may appear as mild redness and may also appear as severe ulceration and skin blistering. In cases where the disorder is caused by allergic reactions, it may show blisters, fine red bumps, skin redness and severe itching. In other cases where it may be caused by plant allergies such as poison oak, sumac and ivy, the infection becomes intense with blisters and or bumps on the places where the plant allergy contacted the skin.
The symptoms of hand eczema are common in winter with cracked and dry patches on the skin. This is not necessarily accompanied by the redness of the skin. Other kinds of hand eczema may show signs such as scaling, itching, skin blisters and bumps. In cases where the patient wears rings, the areas under the rings may be infected first.
The signs and symptoms of nummular eczema mostly start as mere areas of irritation that later turn into round red, scaly and crusted patches. In case such signs and symptoms appear, the patient is advised to seek medical advice soonest possible. This would help the doctor to identify the disorder early enough and prescribe the patient to the right medication to prevent severe cases of the disorder which may cause secondary infections. These secondary infections are brought about by bacteria that may enter into the body through the open patches on the skin that may have been caused by scratching and cracking of the skin. The earlier the disorder is diagnosed the easier it is to treat it.
However, it is possible to prevent and even to reduce the eczema infections. For example, eczema flare-ups can be reduced by avoiding extreme temperatures, harsh soaps, bubble baths, and dry air. It is also advisable to use clothing and blankets made of cotton rather than other irritating fabrics that may include polyester, wool and some stiff synthetics. In addition, after you shower instead of rubbing pat dry the skin in order to leave a little moisture on the skin. After shower, you can apply some moisturizing cream that would help trap moisture to reduce dryness on the skin. Further, in winter it is always good to use humidifiers in order to add moisture indoors.
In case of contact dermatitis, you need to avoid direct skin contact with the irritants and substances that may trigger skin irritation and discomfort. Those patients who have severe varicose veins, they can prevent the stasis dermatitis by elevating their legs when they sit for long and by putting on compression stockings. Therefore, it is important to observe any changes within 48 hours after taking the medication. If there is reaction then the patient should see a doctor immediately.
Medications
Eczema cannot be diagnosed by a single test. However, a good examination of the skin history and medical history are necessary for diagnosing eczema. Taking care of the skin is important in treatment of eczema. In some cases, where individuals are just suffering from mild eczema, modifying of their routine skin care is all that is needed. In addition, making a few changes in their lifestyle would be critical in controlling the disorder (Moscou, K & Snipe, 2009). However, in severe cases, it may be necessary to use drugs in order to control the disorder. The table below shows some of the drugs that are related or used in eczema treatment.
The table 1
Classification

Generic name

Formulations available

Standard Dosage range

topical steroids

Desonide/ DesOwen

Ointments, creams, aerosols, solutions and gels

Mild to very potent

antihistamine

Hydroxyzine/ atarax

Tablets

Severe allergies

corticosteroids

Methylprednisolone/medrol

Tablets

Lowest effectiveness

Topical steroids

Tazarotene/Tazorac

Lotions, creams and shampoos

mild

Eczema as mentioned earlier on in the paper is a group of skin disorders and infections and can affect people of all age groups. Most of the disorders can be prevented and or reduced. Severity of the disorders varies from one individual to another. However, most of them are treatable. There are various medications used to treat, prevent and manage the skin disorders. In its early stages or in mild appearances, eczema may show dry skin, itching, and hot skin. In severe cases the skin may become raw, crack and bleed. Eczema is not contagious though it may appear unpleasant. Therefore, with treatment it is possible to reduce the inflammation of the disorder. However, the skin is always sensitive to flare-ups and will need special care.
Various drugs are used and others related to the treatment of eczema. An infected skin is susceptible to various viral and bacterial infections. When the skin is infected it may ooze honey colored or a clear fluid. The genetic basis of dermatitis was discovered in the year 2008 and it was said to be caused by mutations to filaggrin gene. This gene impairs the skin`s barrier function hence the infection and the disorder. The following are just some of the drugs used in treatment, management, and prevention of eczema.
Mechanism of actions
Antihismines are effective by blocking the effects of histamine. Histamine is responsible for most of the common allergy signs and symptoms experienced. When it is released it binds to receptors in the cells around the throat and the nose. This makes the receptors to swell releasing leak fluid. The leaf fluid causes sneezing, itching, inflammation, runny nose among other symptoms.
An antihistamine stops the effects of histamine by the coating of receptors which prevents their binding. In turn, this coating prevents the symptoms of eczema. Once histamine is released it works quickly. By the time the symptoms are showing, the chemical has already attached to the receptors and the allergic effects are underway. Therefore, it is important to take the antihistamines about two to five hours before being exposed to allergens. However, they can be taken on a regular basis. Some of the antihistamines get to work in about ten to fifteen minutes after you have taken them. The allergic reaction can be stopped if the antihistamines are taken before one is exposed to antigens. This is because they get to their peak in about an hour after one takes them ...