Skin Conditions

Skin conditions typically appear as red, bumpy, itchy skin can be irritating, painful and embarrassing. Rashes can be caused by many things, including exposure to certain plants (poison ivy, for example), allergic reactions to a medication or a food. Rashes can also be caused by an illness such as measles or chickenpox. Eczema and hives, both of which are related to allergies, are two of the most common types of skin rashes.

1. Hives and Angioedema
2. Atopic Dermatitis (Eczema)
3. Allergic Contact Dermatitis

What are the symptoms of Hives?

1. Urticaria is itchy, red and white raised bumps or welts that range in size and can appear anywhere on the body.
2. Angioedema often appears on the face around the eyes, cheeks or lips. This deeper layer of swelling can also occur on hands, feet, genitals, or inside the bowels or throat.
3. In acute urticaria, the welts disappear within minutes to a few weeks. Chronic hives last for months or even years.

How are hives diagnosed?

1. In the majority of chronic cases, the exact cause cannot be determined.
2. Routine testing such as general blood counts or screens are not cost-effective, nor do these tests make a difference in treatment strategies to relieve the symptoms.
3. There are certain instances when allergy testing is helpful, especially when eating a particular food or coming in contact with a particular substance triggers symptoms of acute hives.

What are the symptoms of eczema?

1. Itchy, red or dry skin. It may “weep” or leak fluid that crusts over when scratched, which means that it is also infected.
2. In infants, eczema often appears on the face. Children are prone to have the rash at the bends of the elbow joint, wrists, behind the knees and behind the ears. Adolescents and young adults typically have the rash in the same locations as children, as well as on the hands and feet.
3. Patients with the faulty filaggrin gene often have hand eczema with excessive little lines on the skin of their palms.

How is eczema diagnosed?

1. In many children, the exact cause of the eczema is not clear and treatment depends on regular use of moisturizer and topical medicines to dampen down the inflammation. One such treatment is topical steroids. In children where the skin is oozing, crusting and painful, an infection that needs treatment with antibiotics may be the primary trigger.
2. Infants and young children with more severe eczema should be evaluated for food allergy. It’s important to see an allergist / immunologist for diagnosis and management. It is often needed to receive input from a dietitian as well.
3. Food allergies causing eczema are much less common in older children and adults. If you are suspected of having eczema that is caused by a food allergy, a confirmed diagnosis requires avoiding the trigger food for about four weeks with the help of a dietitian before doing a food challenge under your doctor’s supervision to confirm that the food was actually causing the flare.

What are the symptoms of allergic contact dermatitis?

1. A red rash
2. Itching, which may be severe
3. Dry, cracked, scaly skin
4. Bumps and blisters, sometimes with oozing and crusting
5. Swelling, burning or tenderness

How is allergic contact dermatitis diagnosed?

1. The diagnosis is made from history (what your doctor learns from talking to you including your hobbies, your work exposures, cosmetic/fragrance/hair dye/nail polish exposures, exposure to jewelry and other metals), physical exam and testing.
2. A patch test is used for the diagnosis of contact dermatitis. A small amount of diluted test allergens are applied to the skin under a patch of paper tape. The patches are placed on the back and are removed after 48 hours. Skin reactions are looked at and scored at a 48 hour visit and then again after 72 to 96 hours. Testing allows identification of chemicals you are allergic to so that they can be avoided in the future