Inflammatory Skin Conditions

Eczema (Dermatitis) 

Eczema is a general term for dry, itchy, inflamed, scaly patches of skin, marked by redness, blisters, cracks, oozing, crusting and scaling. It usually affects the knees, elbows and nape of the neck, on the face, and around the eyes. It can also affect the lips, palms, and other areas. Scratching and rubbing can increase inflammation, make itching worse, and cause infection. The rash may become rough and leathery, oozing and crusty, and darken the affected skin.  

Flare-ups are common, followed by periods of improvement. It can affect children on their faces and scalp, often with weeping lesions and extreme itchiness. Eczema can be acute or chronic. 

Eczema seriously impacts a patient’s quality of life, and overall health, increasing the risk of skin infections, anxiety and depression.  It has been linked with an increased risk of asthma, hay fever, food allergy, obesity and heart disease.  

Treatment is aimed at healing the affected skin and preventing flare-ups. Prescription medications are indicated. Phototherapy is the application of UV light (UVA, UVB or a combination) to reduce itching and inflammation and increase vitamin D production. Phototherapy is used in all cases of eczema in adults, and for children with severe symptoms.  

Atopic dermatitis 

Atopic dermatitis (AD) is common worldwide. People of all ages from newborns to adults 65 years of age and older live with this condition. Symptoms range from excessively dry, itchy skin to painful, itchy rashes that cause sleepless nights and interfere with everyday life. Atopic dermatitis is common. 1 in 10 Americans has atopic dermatitis. In the United States, research indicates that African American and Asian American children develop AD more often than white children. 

Contact Dermatitis 

When something that touches your skin either irritates it or causes an allergic skin reaction, you develop this skin disease. The first sign is often itchy skin, followed by a rash. You may also see blisters. 

Contact dermatitis is not contagious, so you cannot give it to anyone else. Because so many things can irritate our skin or cause an allergic skin reaction, contact dermatitis sends many people to see a dermatologist. 

Lupus 

Lupus of the skin is an autoimmune condition where the immune system attacks healthy skin cells causing redness, itching, pian and scarring. It can occur alone or develop in people diagnosed with systemic lupus erythematosus.  There is no cure, but treatments can improve symptoms. 

Psoriasis 

Psoriasis is an autoimmune disorder that tends to run in families. It triggers the immune system to grow new skin cells too fast which results in a buildup that creates a psoriasis plaque.  

The plaques are raised, inflamed and scaly patches of skin on the elbows, knees, lower back and scalp that itch, burn and sting. However, plaques can appear anywhere including on the eyelids, ears, mouth and lips, skin folds, hands and feet and nails.  

Psoriasis can be mild, moderate or severe. Severity is determined by the surface area that is affected and the impact it has on the patient’s quality of life. Both men and women suffer from psoriasis, and all racial groups. It can develop at any age, but frequently develops between ages 15 and 35.  

What can trigger psoriasis?  

Plenty of everyday things can act as a trigger, causing psoriasis to appear for the first time. Common psoriasis triggers include:  

That’s why it’s so important for people who have psoriasis to know what triggers their psoriasis. Avoiding triggers can reduce psoriasis flares.  

Treatment depends on the location and severity of the scaly patches.  When it is limited to a particular part of the body, the treatments are often light therapy(phototherapy) and topical creams and ointments.  But, if it causes a significant impact on a patient’s quality of life, your provider may prescribe systemic drugs, in combination with other treatments. When it appears in numerous areas, oral and injectable drugs may be prescribed. 

Rashes 

A skin rash is any inflammation of the skin. It may be a scaly, bumpy, itchy or irritated area of the skin. It is not a diagnosis. Skin rashes are common and can be caused by infections, heat, allergies, immune system disorders and medications. Common rashes are eczema, psoriasis, rosacea, and dermatitis, poison ivy and poison oak, and hives.  With many rashes there is a genetic predisposition.  

Ringworm 

Ringworm is not caused by worms. It is caused by fungi called dermatophytes. It is caused by contact with an infected person or animal such as a cat. The rash appears as a red ring with a clear center and scaly or bumpy raised edges. It is very itchy and can spread and enlarge. It is treated with antifungal medications and improves quickly. 

Rosacea 

Rosacea is a common, chronic, inflammatory disease of the skin on the face. It causes frequent flushing and redness that spreads from the nose to the cheeks, forehead and chin, often accompanied by a burning sensation, particularly when face creams and cosmetics are applied. Additional symptoms are dilated blood vessels, acne-like breakouts, red and swollen eyelids that burn, irritated eyes and light sensitivity. The condition may flare and then calm down. In advanced cases it can cause a disfiguring condition that appears as a bulbous, enlarged red nose and puffy cheeks. This usually happens to men. 

Over 16 million people in the U.S. suffer with Rosacea. It affects women more often than men, but men tend to have more severe cases.  People of color and all ages can get rosacea. It affects fair skinned people in middle age and older. The cause is unknown, but the tendency to develop rosacea is inherited.  

The goal of treatment is to control the condition and improve the patient’s appearance. Untreated rosacea will get worse over time. Treatment options depend on the severity of the disease and may include antibacterial washes, topical creams, Retin-A, antibiotics, laser, intense pulsed light (IPL), and photodynamic therapy. Often a combination approach is used. Topical medications include Metrogel, an antibiotic that has been shown to significantly improve rosacea, and Azelaic acid called Finacea is also effective to control redness and bumps.  

Scleroderma 

Scleroderma is an autoimmune disease that affects the connective tissue causing a thickening and hardening of the skin. It may be localized to the skin or be systemic causing hardening of the connective tissues in the body including the bones and muscles, and internal organs. The severity varies. 

These are some of the most common inflammatory skin conditions. When you develop a rash that doesn’t resolve within a week, it is time to contact Dr. Pantea Hashemi to receive a diagnosis and all your treatment options. Contact her at the University Skin Institute in Sacramento, California.