When a patient is diagnosed with eczema, the diagnosis of another medical condition may not be far behind.
"Although it affects the skin, eczema is not just skin-deep. This disease can have a serious impact on patients' quality of life and overall health, both physically and mentally," says board-certified dermatologist Jonathan Silverberg, MD, PhD, MPH, FAAD, an assistant professor in dermatology, medical social sciences and preventive medicine at the Northwestern University Feinberg School of Medicine in Chicago.
Eczema, also known as atopic dermatitis, is characterized by dry, red patches of skin accompanied by intense itchiness. Although this disease is most often diagnosed in infancy and early childhood, it may continue or first emerge later in life for some patients. Recent estimates indicate that atopic dermatitis affects one in four children in the United States, as well as up to 7 million adults.
According to Dr. Silverberg, this disease can increase patients' risk of developing allergic disorders like asthma, hay fever and food allergy, as well as other health conditions like obesity and cardiovascular disease. Although the exact reasons for these connections are unclear, he says, they may be the result of eczema-related inflammation affecting the entire body, or atopic dermatitis symptoms negatively impacting patients' sleep and health habits.
Eczema patients also have an increased risk for multiple types of infection, Dr. Silverberg says. Because the disease compromises the skin barrier, he says, patients can develop bacterial skin infections like impetigo, which causes red sores on the face, and cellulitis, a potentially serious condition characterized by redness, swelling, warmth, and pain or tenderness. Atopic dermatitis also affects the immune system, he says, which puts patients at risk for internal infections, including those of the upper respiratory tract and urinary tract.
Even more common in atopic dermatitis patients are conditions affecting their mental health, including anxiety and depression arising in response to eczema symptoms, Dr. Silverberg says. Moreover, he says, these conditions may be aggravated by sleep disturbance, which is a problem for most people with atopic dermatitis.
Patients' itching may get worse at night, or they simply may be more aware of it, Dr. Silverberg says, so they often find themselves unable to fall asleep or waking up several times during the night. Further, he says, a lack of sleep can aggravate eczema symptoms, which can further impact sleep, creating an unpleasant cycle for patients.
According to Dr. Silverberg, controlling flares of atopic dermatitis can help to improve some related conditions, like sleep disturbance. In patients with long-lasting eczema, however, other comorbidities, like cardiovascular problems, may develop as a result of the disease's cumulative effects on the body over the years, he says. For this reason, he says, treatment should focus on not only improving symptoms in the short term but also managing the condition in the long term.
"Atopic dermatitis can be extremely frustrating for patients, but there are effective treatments available, as well as several new treatment options in development that look very promising," Dr. Silverberg says. "If you're struggling with eczema, a board-certified dermatologist can devise an appropriate treatment plan that can help improve your symptoms and your overall quality of life."
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