12 December 2018
WEDNESDAY, Dec. 12, 2018 (HealthDay News) — Nearly 28 million Americans are affected by the skin condition eczema, and for some it may become so chronic and severe they consider suicide, new research shows. A new review of data from 15 studies, involving over 300,000 people, found that those with eczema had a 44 percent higher risk of suicidal thoughts compared with people without the immunological disease. People with eczema also had a 36 percent higher rate of suicide attempts, the study found. Eczema, clinically known as atopic dermatitis, often brings a “profound psychosocial burden” to patients, concluded a team led by Dr. April Armstrong, of the University of South California (USC) Keck School of Medicine, Los Angeles. Eczema is an inflammatory skin condition that often involves painful itch, blisters and sores. People can also have trouble sleeping due to itchiness and other symptoms. The disease can vary in severity and can be socially debilitating, prior research has shown. One such study involved 600 eczema patients interviewed by researchers at Northwestern University in Chicago. That study found that even for people with mild eczema, nearly 18 percent said they avoided socializing because of their appearance, while 23 percent said they limited their daily activities. Those figures rose to 40 percent and 43 percent, respectively, when moderate and severe patients were included. The findings were published in July in the Annals of Allergy, Asthma and Immunology. In the new study, the USC team found similar issues plaguing eczema patients. “Because of the visibility of the disease, patients may experience shame, embarrassment and stigmatization,” Armstrong’s team said. This can affect a child’s performance at school or an adult’s ability to thrive in the workforce, they explained. To learn more, the investigators analyzed data from 15 studies on eczema’s emotional toll on patients. The findings showed that “patients with atopic dermatitis are at significantly greater risk of suicidal ideation and suicide attempts,” and the level of distress rose along with the severity of the skin disease, according to the report. For example, while less than one percent of people with mild eczema said they had suicidal thoughts, that number rose to nearly 20 percent for those with severe disease, the researchers found. Two skin specialists weren’t surprised by the findings. Eczema “can be mentally stressful for patients who suffer from it,” said Dr. Michele Green, a dermatologist at Lenox Hill Hospital in New York City. She believes the study reinforces the need for treatments that minimize the illness, to help patients mentally cope. Dr. Raman Madan practices dermatology at Northwell Health’s Huntington Hospital in Huntington, N.Y. He said that people with eczema often have to deal with concurrent health issues — conditions such as asthma, allergic rhinitis (hay fever), metabolic syndrome and sleep disturbances. Now, the new study “casts light that dermatologists should screen for mental health in [these] patients,” as well, Madan said. For their part, Armstrong’s team stressed that treatments that ease eczema severity are available. Immune-targeted treatments, “such as interleukin 4 and interleukin 13, have been shown to decrease symptoms of depression and anxiety in patients,” the study authors wrote. And as physical symptoms subside, and the social stigma around the illness eases, “we can work toward reducing suicidality in patients with [eczema],” the team noted. The new findings were published online Dec. 12 in JAMA Dermatology. More information For more on eczema, visit the U.S. National Institute of Allergy and Infectious Diseases.
03 December 2018
MONDAY, Dec. 3, 2018 (HealthDay News) — About 10 percent of people will suffer from the itchy skin condition known as eczema at some point in their lives, new research shows. And though it is widely thought of as a pediatric condition, seniors are also highly vulnerable, the study suggests. The report did confirm that eczema risk is common among children, affecting as many as 1 in 5 infants and toddlers. That risk starts to drop off by the time people reach young adulthood and middle age. But when people reach their 70s, their risk goes up again, with 1 in every 10 seniors affected. “Eczema — also known as atopic dermatitis — is an itchy inflammatory skin disease,” explained study author Dr. Katrina Abuabara, an assistant professor in the department of dermatology at the University of California, San Francisco. “Because eczema often develops early in life and waxes and wanes over time, most research has focused on children,” Abuabara said. “Ours is the first large study to examine rates of active physician-diagnosed disease across the entire life span,” she said. “Similar to other reports, we found declining rates of active disease across childhood. We were surprised, however, to find steady rates of active disease throughout adulthood and increasing rates in older age.” To explore how eczema risk plays out over one’s lifetime, Abuabara and the research team analyzed statistics regarding eczema cases on British residents between 1994 and 2013. In all, the data concerned more than 8.6 million patients, ranging from infancy up to age 99. Ultimately, the team found that individuals appear to face a 1 in 10 chance for developing eczema at some point in their lives. But risk did vary across age groups. In fact, Abuabara noted, the risk follows a “U” shape: “It is highest in childhood, dips among young adults, and rises in mid-to-late adulthood,” she said. Specifically, the researchers found that a near 20 percent risk among very young children starts to decline steadily during the preteen years, ultimately hitting a low of about 5 percent by the time people reach age 20. Thereafter risk hovers steadily at that level, only to start a slow ascent again when individuals hit their late 50s. The findings were published in the Dec. 3 issue of the Annals of Internal Medicine. As for treatment, Abuabara said the gold standard involves moisturizers, topical corticosteroids, phototherapy and immunotherapy drugs, as needed. She also noted that “the U.S. Food and Drug Administration approved two new medications for eczema in 2016 and 2017, and more than a dozen additional agents are under development and clinical testing, offering hope for more personalized and targeted treatments.” Dr. Robert Kirsner, chairman of the University of Miami Miller School of Medicine’s department of dermatology and cutaneous surgery, characterized current treatment options as “limited.” He was not involved with the study. “Cost is an issue, and potential side effects of oral medications may also be an issue,” Kirsner said. And only one injectable drug has been approved by the FDA, so insurance companies do not always agree to pay for medications, he said. However, he noted that “new medications are being developed, which will likely add tools to help alleviate patient suffering.” Meanwhile, the study “confirms other recent data suggesting that common eczema persists into adulthood,” Kirsner said. “The fact that eczema is less common in young adults and middle-aged [people] suggests that either childhood eczema wanes over time and recurs, or that it wanes and new cases develop in late adulthood,” he said. Regardless, Kirsner noted that “for a long time it was the thought that the majority of childhood cases of eczema resolve, but this is clearly not the case.” More information The U.S.-based nonprofit National Eczema Association has more on eczema.
13 October 2018
SATURDAY, Oct. 13, 2018 (HealthDay News) — Bleach baths can ease symptoms of moderate to severe eczema and reduce the risk of skin infections, a dermatologist says. Eczema causes itchy, red, scaly skin. It’s often triggered by cold weather or allergens, and can be a chronic source of discomfort. “Bleach is antibacterial, and studies have shown that a diluted bleach bath may reduce eczema symptoms by reducing bacteria and inflammation on the skin,” said New York-based dermatologist Dr. Ross Radusky. “However, it’s important to follow your dermatologist’s recommendations carefully in order for this treatment to be safe and effective,” he said in an American Academy of Dermatology news release. A bleach bath may be helpful a few times a week, but using it daily can cause too much drying of the skin, Radusky said. To prepare a bleach bath, use regular strength (6 percent) plain bleach. Do not use splashless or concentrated bleach, or bleach that has fragrance. Use a half cup of bleach for a full bathtub of water; a quarter cup of bleach for a half-full tub of water; or 1 teaspoon of bleach per gallon of water for a baby or toddler bathtub, Radusky said. Pour the bleach into the running bath water while the tub is filling and wait until your bath is fully drawn before you get into the tub. Use lukewarm water. Hot water can dry out the skin, causing an eczema flareup. Don’t put your head in the water; only soak from the neck down. Ask your dermatologist how long you should soak — a five- to 10-minute soak is generally recommended. Afterwards, turn on the shower and gently rinse your skin with lukewarm water, but no soap, Radusky said. Gently pat your skin dry after the bath. Use white towels if you are concerned about bleach stains. If your eczema requires medication, apply it immediately after the bath, then apply your moisturizer. Never apply bleach directly to your eczema, Radusky said. “Keep in mind that bleach baths are one component of an overall treatment plan that includes medicine and a good skin care routine,” he said. Eczema, also called atopic dermatitis, affects nearly 28 million Americans. More information The American Academy of Dermatology has more on eczema.
19 September 2018
WEDNESDAY, Sept. 19, 2018 (HealthDay News) — Eczema, or atopic dermatitis, can be very difficult to control in some people. But the skin condition, which leads to dry, itchy and inflamed skin, is particularly problematic for black people, according to new research. Scientists who examined patients’ skin on a molecular level found that compared to Americans of European ancestry, African Americans may require higher doses of some medications to manage stubborn eczema symptoms. “Research shows about 19 percent of African Americans and 16 percent of European Americans are diagnosed with atopic dermatitis,” said study lead author Dr. Emma Guttman-Yassky. She is a professor of dermatology at Icahn School of Medicine at Mount Sinai, in New York City. “Our study found there are significant differences in the skin of people with atopic dermatitis than in those without the condition,” she added. “Furthermore, we found African Americans with atopic dermatitis have more inflammation than European Americans with the condition,” Guttman-Yassky said in a news release from the American College of Allergy, Asthma and Immunology. Scientists are using molecular skin profiling to develop more effective treatments for eczema. Previous research, however, had only included European Americans with the skin condition, the study authors explained. So the new study compared the molecular profile of the skin in eczema patients of African descent with patients of European descent, looking for differences that might help researchers improve treatment options for black people. “The results indicated that the immune profile was more unbalanced in African Americans with atopic dermatitis compared to European Americans,” Guttman-Yassky said. The study authors said this was the first molecular study to seek out and identify differences that could help doctors understand why eczema is often more severe and difficult to control among black people. The findings were published in the Sept. 14 issue of Annals of Allergy, Asthma and Immunology. According to allergist Dr. Donald Leung, executive editor of the journal, “This may prove to be a valuable enhancement for treatment options for African Americans with atopic dermatitis. It will also reinforce the importance of racial diversity in clinical research studies for effective treatment” for the skin condition. More information The U.S. National Library of Medicine has more on eczema.
16 July 2018
MONDAY, July 16, 2018 (HealthDay News) — Itching, blisters, sores and inflammation are a continuous and debilitating source of pain, shame and misery for many people who struggle with the allergic skin disease known as eczema, researchers say. And a new survey suggests that many of those battling moderate-to-severe eczema suffer from an inability or reluctance to engage in activities and socializing, which leads to a considerably diminished quality of life. For some eczema patients, their quality of life is poorer than those who have a wide range of other chronic health issues, including heart disease, diabetes and high blood pressure, the researchers added. “The more severe the atopic dermatitis [eczema], the worse the overall health, quality of life and life dissatisfaction,” said study author Dr. Jonathan Silverberg. “I see some of the toughest cases of atopic dermatitis around, so I can’t say I was terribly surprised by this,” Silverberg explained. “But I think most people who don’t live with atopic dermatitis are surprised to hear just how debilitating it can be.” Silverberg serves as director of the Northwestern Medicine Multidisciplinary Eczema Center and the Contact Dermatitis Clinic at Northwestern Memorial Hospital, in Chicago. According to the National Eczema Association, roughly 30 million Americans — ranging from infants to seniors — suffer from one of several different forms of the skin disease. The exact cause remains elusive, and there is no known cure. And though topical drugs and immunotherapy can help manage the condition, treatment is complicated by the fact that “no two eczema patients are exactly alike,” Silverberg said. “For most patients, flares can come for no apparent reason at all,” he noted. “Many patients are looking for that one [environmental] trigger they can avoid to cure their atopic dermatitis. For most, it doesn’t exist.” And that means that patients with different triggers and different degrees of severity and symptoms will require a different “tailored treatment approach” for what will likely end up being a long-term chronic disorder, said Silverberg. The survey of just over 600 eczema patients (with mild, moderate, or severe disease) revealed one all-too-common thread: a broad dissatisfaction with one’s life. Nearly three-quarters of those polled were white. Just over half had mild eczema, nearly four in 10 had a moderate condition, and just over 8 percent described their condition as severe. Pooled together, about one-quarter said they were in fair health, while nearly 16 percent described their overall health as poor, the findings showed. Among those with severe disease, about 35 percent said they were either in fair or poor health, while almost one-third said they were somewhat or very dissatisfied with life. But even among those with mild eczema, nearly 18 percent said they avoided socializing because of their appearance, while 23 percent limited their daily activities. Those figures shot up to 40 percent and 43 percent, respectively, when moderate and severe patients were included. The most effective way patients can limit eczema’s impact on quality of life is to “seek care earlier and aim for tighter control of their symptoms,” Silverberg advised. “Some patients may say to themselves ‘it’s not so bad,’ and not seek care,” he said. “Then they end up suffering in silence as things worsen and they eventually get to a point of desperation, and at that point have a much harder time treating their disease.” The impact that eczema can have on life satisfaction is not lost on Dr. Richard Gallo, chairman of dermatology at the University of California, San Diego. “We have long known that eczema has an enormous impact on the quality of life, not only for the patient but also on parents of children with eczema,” he said. Still, “there is good news for eczema patients because of new scientific understanding of the cause and treatment,” Gallo added. On that front, he highlighted work currently underway exploring the potential benefits of using probiotics applied to the skin. But, Gallo said, “eczema is complex and patients really need to talk carefully to their doctor to understand the type and causes of their eczema.” The study was published July 16 in Annals of Allergy, Asthma and Immunology. More information For more on eczema, visit the U.S. National Institute of Allergy and Infectious Diseases.
24 May 2018
THURSDAY, May 24, 2018 (HealthDay News) — Sufferers of severe eczema may be at greater risk for heart attack, stroke and irregular heartbeat, British researchers report. Although the added risk is small, it’s important from a public health perspective because eczema affects up to 10 percent of adults, the researchers said. Eczema is a term for several types of skin swelling marked by dry, itchy skin and rashes. Because this was an observational study, the researchers couldn’t prove eczema caused the increased heart disease risk. But they said that, given the large number of people included in the study, the association appears strong. Dr. Sinead Langan, of the London School of Hygiene and Tropical Medicine, led the international research team. To quantify the risk, the researchers analyzed data for more than 385,000 adults (average age 43) with eczema. Each was matched with up to five people of similar age and gender who didn’t have eczema. Patients were classified as having mild, moderate or severe eczema and were followed for an average of five years. Those with severe eczema had a 20 percent increased risk of stroke and a 40 percent to 50 percent greater risk of unstable angina, heart attack, atrial fibrillation and death from heart disease. This group also had a 70 percent increased risk for heart failure, the study authors said. These risks remained after the researchers accounted for such factors as weight, smoking and alcohol use. Their findings were published May 23 in the journal BMJ. “Severe and predominantly active atopic eczema are associated with an increased risk of cardiovascular outcomes. Targeting cardiovascular prevention strategies among these patients should be considered,” the researchers said in a journal news release. In an accompanying editorial, Dr. John Ingram, a consultant dermatologist at Cardiff University in Wales, said these results helped clarify the conflicting evidence about eczema and heart disease risk. The findings may also shed light on the value of using costly new biologic drugs to control severe eczema. Exploring whether these drugs can reduce heart disease risks is the next step, Ingram said. More information To learn more about eczema, visit the American Academy of Dermatology.
03 May 2018
THURSDAY, May 3, 2018 (HealthDay News) — A treatment that harnesses the power of helpful bacteria living naturally on the skin might be a breakthrough treatment for eczema, early research suggests. The therapy capitalizes on recent insights into the importance of the “microbiome” — the trillions of helpful bacteria that live in people’s digestive tracts and on their skin. “By applying bacteria from a healthy source to the skin of people with atopic dermatitis [eczema], we aim to alter the skin microbiome in a way that will relieve symptoms and free people from the burden of constant treatment,” explained the study’s lead researcher, Dr. Ian Myles. Eczema is an inflammatory skin ailment that renders the skin itchy and dry, and vulnerable to rashes and infections. Both adults and children can suffer from the condition. The exact cause of the illness isn’t known, but it’s believed that bacteria and other microbes that live on the skin could play a major role. In the new research, live Roseomonas mucosa — a bacterium that’s naturally present on the skin — was taken from people without eczema and applied to the skin of 10 adult and five pediatric eczema patients. Twice weekly for six weeks, adult participants spritzed sugar water containing increasing amounts of the “good” bacteria onto their inner elbow and one other skin area of their choice. They also continued with their regular eczema treatment. Kids in the study underwent a similar protocol for 12 weeks, then upped the dose to every other day for another four weeks. After a few weeks, the severity of the patients’ eczema was reduced, and some reported being able to cut back on steroid creams they’d used to treat their eczema. No complications from the treatment were reported, according to the study authors. Overall, six of the 10 adults and four of the five children had a greater than 50 percent improvement in their eczema symptoms by the end of the trial. “This study has exciting potential for one day having a treatment for the millions of sufferers of eczema,” said Dr. Michele Green, a dermatologist at Lenox Hill Hospital in New York City. “What is most exciting is that the ‘cure’ may be through the skin microbiome itself,” said Green, who wasn’t involved in the new study. There was one other interesting finding: Certain chemicals called parabens, commonly found in moisturizers and other skin care products, were found to inhibit the growth of R. mucosa. That suggests that these products might hinder the skin’s defenses against eczema, Myles’ group said. The research was funded by the U.S. National Institute of Allergy and Infectious Diseases (NIAID) and published May 3 in the journal JCI Insight. “If future clinical studies demonstrate that this strategy is effective, we hope our work will lead to development of new, low-cost atopic dermatitis therapies that do not require daily application,” Myles, an NIAID researcher, said in an institute news release. Dr. Anthony Fauci is the agency’s director. “Living with atopic dermatitis can be physically and emotionally challenging,” he said in the release. “While treatment can help manage the symptoms, currently available therapies can be time-consuming — requiring multiple daily applications — and costly. “New, inexpensive therapies that require less frequent application are needed to expand the options available for atopic dermatitis treatment,” Fauci said. More information The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more on eczema.
07 December 2017
THURSDAY, Dec. 7, 2017 (HealthDay News) — Bathing in water is just as effective for the treatment of eczema as bathing in a bleach solution, a new review of previous research indicates. Doctors sometimes recommend a bleach bath, which is a mixture of a small amount of bleach in a pool of cool or warm water. But investigators say the finding should encourage people with eczema to bathe regularly with just water, without fear of drying out their skin. It should also help people avoid the stinging and burning that can come with a bleach bath. “I don’t know if it throws the baby out with the bathwater, but bleach baths lack the evidence to support how commonly they are being recommended,” said senior author Dr. Jonathan Silverberg. “The water baths appear to be doing most of the heavy lifting. If bleach is adding any benefit, it’s quite modest.” Silverberg is an assistant professor of dermatology at Northwestern University’s Feinberg School of Medicine in Chicago and director of its Multidisciplinary Eczema Center. Bathing with a bleach solution is sometimes prescribed as a means of controlling both bacterial infection and symptoms, the researchers noted. But their review, which analyzed data from four earlier studies, suggests that it’s no more effective at either task than simply bathing in water. In addition, because many people with eczema also struggle with asthma, bleach fumes can also trigger asthma attacks. “Patients with eczema have much higher rates of asthma than non-eczema patients,” Silverberg said in a Northwestern news release. “Everyone’s home setting is going to be different, and many bathrooms don’t have great ventilation, so a warm bath that causes the bleach to fume can be the perfect setup to potentially have an asthma flare-up,” he said. The findings are outlined in a recent issue of Annals of Allergy, Asthma and Immunology. More information The U.S. National Institute of Allergy and Infectious Diseases has more on eczema.
04 December 2017
MONDAY, Dec. 4, 2017 (HealthDay News) — Parents can get a reliable diagnosis for their child’s skin condition simply by taking a smartphone photo and sending it to a dermatologist, new research suggests. The finding offers a way to get around what experts describe as a dire shortage of pediatric dermatologists. “Advances in smartphone photography, both in quality and image transmission, may improve access to care via direct parent-to-provider telemedicine,” said study author Dr. Patrick McMahon. He is a pediatric dermatologist at Children’s Hospital of Philadelphia. “Our study shows that — for the majority of cases — parents can take photographs of sufficient quality to allow for accurate teledermatology diagnoses in pediatric skin conditions,” McMahon said in a hospital news release. “This is important because pediatric dermatologists are in short supply, with fewer than 300 board-certified physicians serving the nation’s 75 million children,” he added. The study involved 40 families. Half of them were given photo-taking instructions, while the other half were not. Most were using an Apple iPhone. The researchers then analyzed all images of pediatric skin conditions that were sent in between March and September of 2016. Of 87 images, a digital diagnosis was in sync with an in-person diagnosis 83 percent of the time, according to the report. The study authors noted that of the 200 million pediatric office visits that take place across the United States each year, 10 percent to 30 percent involve skin concerns. “While many children’s skin conditions can be handled without input from a pediatric dermatologist, the national shortage of specialists is a known barrier to accessing care,” McMahon explained. “Our findings suggest that telemedicine could improve access for patient families who have geographic, scheduling or financial limitations, as well as reducing wait times,” he said. The findings were published recently in the journal JAMA Dermatology. More information The U.S. National Institutes of Health has more on skin conditions.