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Eczema or Dermatitis and Allergy
Eczema or Dermatitis is the commonest inflammatory condition of the skin. It can be divided into three types; endogenous (atopic), allergic and irritant.

Atopic Dermatitis
Starts in early childhood and usually in the skin creases. May persist or re-occur as an adult mainly on the hands, feet and face. Most cases are mild but occasional it can be severe and require strong treatment to control. Associated with asthma and hayfever. Fillagrin gene mutation allows for the skin water barrier to be less efficient. This causes excessive skin dryness and soreness leading to skin inflammation (dermatitis). The immune system tends to respond in a different way to normal which compounds the situation. Allowing the skin to dry out, skin infection and (very rarely diet) can cause flares of eczema.

Irritant Contact Dermatitis
Skin can dry out and become sore if exposed to irritants. The skin then becomes more sensitive – even to minor irritants. People with atopic dermatitis are more vulnerable to this problem.

Allergic Contact Dermatitis
Substances absorbed through the skin can lead to the development of allergic contact dermatitis. The skin often feels sore rather than itchy. Those with atopic dermatitis are more vulnerable to develop this problem. Common causes include Nickel, Chrome, Cobalt, Perfume, PPD and Colophony. Allergy ‘patch’ testing can confirm the causative chemical or substance.

Urticaria or Hives
Often looking like a nettle rash or bee stings. Very itchy and flares are random and spontaneous. Sometimes aggravated by pressure on the skin, changes in temperature, sweating, water exposure, certain drugs or certain chemicals in the food. The problem is an immune defect (not an allergy) causing histamine release in the skin. An associated condition called angioedema can cause skin swelling especially of the lip or tongue.

Professional Experience in Managing Eczema & Urticaria
Managing eczema, urticarial and a wide variety of skin rashes as a consultant dermatologist since 2000.

Publications in Eczema, Urticaria and Allergy
Downs AMR, Sansom JE. Palmo-plantar dermatitis may be due to phenol formaldehyde resin contact dermatitis. Contact Dermatitis 1998; 39:147
Downs AMR, Lear JT, Sansom JE. Contact sensitivity in patients with oral symptoms. Contact Dermatitis 1998; 39:258-9
Downs AMR, Sharp LA, Sansom JE. Pentaerythritol esterified gum rosin as a sensitizor in Granuflex hydrocolloid dressing. Contact Dermatitis 1999; 41:162-3

Click here to see the rest of the Eczema, Uritcia and Allergy Publications by Dr. Downs

Professional Services Offered by Dr Downs
1. Management of all types of eczema/dermatitis, drug rashes & urticaria
2. Patch tests for allergic contact dermatitis
3. Blood tests for Type 1 allergies

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