Eczema

Question 1

Eczema

Answer 1

Skin inflammation that results from an allergy, and occurs when the immune system attacks itself, also known as a hypersensitivity reaction.

Question 2

Atopic

Answer 2

A group of conditions caused by a decreased activity of the allergy immune system

Question 3

How is eczema triggered?

Answer 3

Starts off with the environment, like an allergen, acting as a trigger. It is able to travel through the slightly porous skin, which is then picked up by an immune cell (antigen presenting cell). It presents the allergen to a t-helper cell, activating it into a TH2 cell.

Question 4

What does the activation of TH2 cells stimulate?

Answer 4

They stimulate nearby B cells to produce immunoglobulin E antibodies specific to the allergen. They bind to the surface of other immune cells called mast cells and basophills.

Question 5

T-Helper cells

Answer 5

Secrete cytokines which communicate with other cells of the immune system and activate them to eliminate pathogens by appropriate immune response.

Question 6

Cytokines

Answer 6

Cell signalling molecules that aid cell to cell communication

Question 7

B Cell

Answer 7

Type of white blood cell that bind to specific antigens and will initiate an antibody response. They produce immunoglobulin

Question 8

What happens during second exposure to the allergen?

Answer 8

The allergen can cross link the immunoglobulin E antibodies, causing the release of pro-inflammatory molecules. The combined effect causes the blood vessels to dilate, attracting more immune cells to the area, creating inflammation.

Question 9

Itch-scratch cycle

Answer 9

The outer layer of skin is weaker and more susceptible to inflammation. The damage done by scratching contributes to the breakdown of skin cells in the body, making it easier for foreign substances to get in. The inflammation makes the skin more leaky, allowing water to escape leaving the skin dry and scaly

Question 10

Genetic causes of eczema

Answer 10

Alternations in filaggrin

Question 11

Alterations in filaggrin

Answer 11

Eczema may be associated with a genetic lack of filaggrin, a protein that binds to keratin fibres in epithelial cells. Keratin gives the epidermis its protective properties. Filaggrin deficiency leads to a leaky skin barrier.

Question 12

Symptoms of eczema

Answer 12

Dry skin, itching, discoloured patches, small raised bumps, sensitive raw skin, thickened scaly skin

Question 13

What makes eczema worse?

Answer 13

Mould, dust mites, changes in the weather, stress and cigarette smoke

Question 14

Atopic triad

Answer 14

Asthma, eczema and allergic rhinitis

Question 15

How does filaggrin impact dry skin?

Answer 15

Filaggrin is converted into the skin’s natural moisturising factor, so a lack of it would cause dry skin.

Question 16

Treatments

Answer 16

Emollients, topical corticosteroids, antihistamines, calcineurin inhibitors,
wet dressing and antibiotics

Question 17

Emollients

Answer 17

Moisturisers used every day to stop the skin becoming dry. They cover the skin with a protective film to trap in moisture.

Question 18

Topical corticosteroids

Answer 18

Creams and ointments used to reduce swelling and redness. They make blood vessels near the surface of the skin tighter, helping to decrease redness.

Question 19

Antihistamines

Answer 19

To reduce itching by blocking the chemical histamine from affecting the cells. Histamine is released when the body detects something harmful.

Question 20

Calcineurin inhibitors

Answer 20

Medicines which inhibit the enzyme that activates T-Cells of the immune system

Question 21

Wet dressing

Answer 21

Involves wrapping the affected area with topical corticosteroids and wet bandages

Question 22

Other methods for treating eczema

Answer 22

Identify and avoid triggers, dress in soft fabrics, manage stress, keep fingernails short.

Question 23

Antibiotics

Answer 23

To treat infection if required.

Question 24

Why does eczema cause itching?

Answer 24

Free nerve fibres are stimulated by nerve endings called C fibres in the epidermis. Nerve pathways are activated and messages travel to the brain

Question 25

Why does eczema cause discoloured pathches?

Answer 25

Pigmentation is controlled by melanin; trauma to the skin can cause a loss of pigmentation in the affected area

Question 26

Why does eczema cause bumps?

Answer 26

Bumps appear when the pores of the skin become clogged with dead skin cells, oil and bacteria