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Dermatitis

The term eczema, which has been in use since the time of Hippocrates, referred to a skin disease of unknown etiology with a chronic progression, characterized by remissions and flare-ups and presenting with itching, skin inflammation, vesicles, and oozing. With the progress of medical science, the causes of certain forms of eczema were identified, thus introducing the term Dermatitis for them (e.g., irritant, allergic, atopic dermatitis, etc.). In practice, the two terms are used interchangeably today.

In its acute phase, dermatitis is characterized by erythema (redness), edema (swelling), vesicles (small blisters with serous content), and pruritus (itching), gradually leading to rupture (of the vesicles) and weeping (serous discharge). As the condition progresses to the subacute phase, erythema and itching decrease, and crusts (from the dried serous discharge of ruptured vesicles) and scales develop. Finally, in its chronic phase, dermatitis is characterized by lichenified plaques due to thickening of the epidermis caused by chronic scratching/pruritus.

Causes

The causes of dermatitis usually involve a combination of genetic predisposition and exogenous factors, which vary depending on the type (e.g., irritating substances like acids or alkalis in the case of irritant contact dermatitis; low molecular weight allergens and sensitization to them in the case of allergic contact dermatitis, etc.).

Additionally, a weakened protective skin barrier, for example due to hereditary factors as occurs in atopy, allows allergens and irritants to penetrate more easily into deeper skin layers.

Flare-ups can be triggered by environmental factors such as stress, chemical irritants (e.g., fragranced soaps, cleaning products), contact with metals (e.g., nickel), as well as a plethora of other factors.

Types of Dermatitis

Usually begins in childhood and may persist into adulthood. It is a chronic disease characterized by remissions and flare-ups. The skin is extremely dry, red, and often intensely itchy (pruritic). The problem is most pronounced in skin creases (e.g., elbows, knees, wrists).

Atopic Dermatitis_Ατοπική Δερματίτιδα

Caused by direct contact with irritating or allergenic substances: caustic chemicals, fragrances, metals, latex, etc. It can appear either locally (e.g., on hands from cleaning products) or generally.

Contact Dermatitis_Δερματίτιδα εξ επαφής

This is a very common type of dermatitis with a clear genetic predisposition, appearing in areas with increased oiliness due to a higher number of sebaceous glands (e.g., scalp, face, beard area, behind the ears, sternum). It is characterized by scaling and redness. Associated pruritus is mild or absent. Erythematous-scaly plaques appear, and the condition is characterized by remissions and flare-ups.

Σμηγματορροϊκή Δερματίτιδα

Nummular eczema (round, red, itchy, scaly, or weeping rashes), dyshidrotic eczema (tiny, clear, hard vesicles on the sides of the fingers), etc.

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Treatment / Management

The management of dermatitis depends on its type and etiology, and aims to reduce inflammation, relieve itching, and enhance skin moisture. The following are usually recommended:

• Daily Moisturization: To restore the skin barrier.

• Topical Treatments: Dermatological products or pharmaceutical preparations for the immediate reduction of inflammation. These help soothe the affected skin and improve symptoms.

• Avoidance of Irritants: We aim to reduce exposure to known irritants (harsh soaps, strong detergents, hot baths) so as not to exacerbate the skin condition.

With appropriate care (cleansing, moisturizing, topical treatment), the symptoms of dermatitis are significantly limited, improving the quality of life for those affected.

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