Daily Archives: October 20, 2019

By the time Mary Elizabeth Bretz was 15, her mother, Christina, thought shed exhausted treatment options for her eczema. We tried everything thats on the counter and more, Christina says. We would go to the doctor constantly with her flare-ups, and they would prescribe a steroidal cream and say it may work, it may not. She says if it did work, it would only work for a short time, leaving them back at square one.

Mary Elizabeth, now 16, had her first flare-up with atopic dermatitis (a term used interchangeably with eczema) at 6 months old, and the symptoms exacerbated when she was in seventh grade. She felt the effects both physically, in the form of cuts and blisters on her skin, and emotionally. It caused me to be very self-conscious, and people would make fun of me, Mary Elizabeth says.

Christina adds that Mary Elizabeth had anxiety and depression because of her physical features. Christina noticed her daughters grades slipping, and she says Mary Elizabeth had trouble concentrating in school and on the soccer field because she was scratching her skin constantly. Soccer was taken away from me because I was in constant pain, Mary Elizabeth says. Sweating hurt so bad.

RELATED: Eczema Triggers and How to Target Them

Thats when Mary Elizabeths dermatologist suggested traveling from their home in Lexington, Kentucky, to Denver, for an intensive two-week wet wrap therapy program.

Photo Courtesy of National Jewish Health and Mary Elizabeth Bretz

Wet wrap therapy is a treatment option for intense eczema flares that are accompanied by itching or pain. Wet wraps work for moderate to severe atopic dermatitis, says Kanwaljit Brar, MD, a pediatric allergist and immunologist at National Jewish Health in Denver, where Mary Elizabeth received her treatment. (Dr. Brar didnt treat her, however.) The therapy isnt designed for mild cases. Its considered a rescue therapy, so its something we do to rescue the skin, Brar says. I like to think of it as a skin reset.

The therapy involves wrapping the affected areas of skin with damp fabric, either for a couple of hours during the day or overnight, which Brar says is the most effective and the most convenient for busy families. The therapy is generally used for a couple of days, according to Seattle Childrens, though Brar says it could be used for up to two weeks for severe cases.

During the first week of Mary Elizabeths visit to National Jewish Health, the wet wraps were applied for two hours in the morning, two hours in the afternoon, and overnight.

RELATED: A Detailed Guide to Eczema Treatment

The goal of the treatment, according to the National Eczema Association, is to rehydrate the skin and make medications soak in more effectively. Brar says it helps restore the skin barrier, reduces water loss, helps heal the abrasions and crusty areas on the skin, and can treat inflammation if the skin is infected. It also serves as a physical barrier, so by covering the area, it can prevent scratching as well, she says.

Wet wrap therapy is often used on children, which parents can administer at home, but it can work for adults, too. Its just a little more cumbersome given the larger bodies and bigger surface area to treat, Brar says.

Essentially, youll apply medication or moisturizer to the affected areas and then wrap the body (or part of the body) with a damp layer followed by a dry layer.

Heres how a full body wet wrap is done, per Seattle Childrens, the National Eczema Association, and Brar:

Wearing the wet clothes can be uncomfortable Mary Elizabeth recalls feeling freezing cold and wet so Brar recommends putting blankets straight out of the dryer on top of the patient for extra warmth.

You can also apply the wet wrap to just the affected areas, say the knees. Brar says in that case, cut the foot off of long socks and use those tubes as the wet layer. Or, if the eczema is on the face, a nurse can help apply a wrap made of gauze and surgical netting, according to National Jewish Health. Brar says to be careful when applying a face wrap to children especially overnight and during naptime because it could shift and end up blocking their nose or mouth.

Mary Elizabeths skin improved dramatically the first night of the therapy. It helped so much within 24 hours, she says. I woke up and it felt tremendously better.

The results will vary from patient to patient, but astudy published in the JulyAugust 2014 issue of The Journal of Allergy and Clinical Immunologyfound the benefits of wet wrap therapy continued one month after treatment ended.

RELATED: Can Essential Oils Help Eczema or Atopic Dermatitis?

The same study noted that in practice, wet wrap therapy is a safe intervention treatment. If youre unsure of how to go about it or want more guidance, speak with a doctor first.

As Mary Elizabeth knows, wearing wet clothes can induce chilling. That was the only side effect noted in aprevious study, though Mary Elizabeth says it was still worth it.

A more serious side effect is the potential increased risk of infection. Areview published in November 2016 in The British Journal of Dermatologyfound a higher incidence of mild skin infections following wet wrap therapy. And astudy published in May 2015 in Acta Dermato-Venereologica found infections were more frequent when corticosteroids were used on the skin rather than moisturizers. Thats a catch, though, because the researchers found using wet wrap therapy with corticosteroids is more effective, so its important to keep a lookout for signs of infection. The researchers found the most common infection was folliculitis, which will look like white-head pimples or red bumps around hair follicles, accordingto the Mayo Clinic.

RELATED: Do You Need a Topical Steroid to Help Control Your Eczema?

Since Mary Elizabeth returned home after that two-week visit to National Jewish Health last November, she hasnt experienced any flare-ups and hasnt needed wet wrap therapy since. Christina now helps administer Dupixent (dupilumab), a biologic medication approved by the U.S. Food and Drug Administration (FDA), twice a month, which has helped keep her daughters symptoms under control.

Mary Elizabeth is no longer scratching her skin continuously throughout the day. I really feel the wet wrap therapy brought her to a level where she could concentrate and she could function like a normal person, Christina says, adding that Mary Elizabeths overall well-being improved and her grades have, too. Teachers noticed, myself and my husband noticed, and she noticed that she was able to concentrate more and the improvement was definitely there in all areas of her life.

Mary Elizabeth has regained self-confidence, too. [My boyfriend] told me when I came back from Denver that he knew I was a changed person because I was just happy in my skin.

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'I Tried Wet Wrap Therapy for Eczema, and It Helped Reset My Skin' - Everyday Health

Purple and orange are the colors for Eczema Awareness Month.

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The symptoms of eczema, commonly known as atopic dermatitis, can be so visible and intense that people living with this skin condition are constantly aware of them. It isnt just the symptoms the incessant itching, the redness, and the inflammation its the sleepless nights, its the depression and anxiety, explains Julie Block, president and CEO of the National Eczema Association (NEA). Its the truth that for many with moderate to severe disease, every waking moment is a decision based on how their skin is.

October is the month when organizations in the United States such as theNEA and the Asthma and Allergy Foundation of America (AAFA) spread awareness about eczema, its causes, the stigma attached to it, and new developments for relieving symptoms. This is especially important because the disease is prevalent in the United States, affecting 9.6 million individuals younger than 18 as well as 16.5 million adults. (1)

What they are grappling with is a chronic, inflammatory skin condition linked to an overreactive immune system. (2,3) Symptoms include skin that is dry, inflamed, itchy, rashy, scaly, or oozing clear fluid when scratched (a symptom called weepy skin). Triggers for flare-ups can be dry skin, allergens such as pet dander or seasonal pollen,chemical irritants such as laundry detergents or scented soaps,stress,hormonal changes,or infections. (3) Eczema may disappear as a child grows older or continue into adulthood. (4)

Most people with mild symptoms can manage eczema with over-the-counter products, says Block. Yet those who have moderate to severe symptoms can feel worn down by the continual need to avoid triggers or the negative reactions that others may have to visible signs of eczema. Take scaly skin, for example. Some people describe their eczema by saying, Im allergic to life, says Block. The isolation that some people feel is kind of numbing.

In fact, a review published in December 2018 in JAMA Dermatology found that people with eczema are 44 percent more likely to have suicidal thoughts and 36 percent more likely to attempt suicide than those who do not have eczema. The study authors write that contributing factors may be severe symptoms such as pruritus (the urge to scratch), pain, burning, and sleep loss, as well as stigma and feelings of shame. (5)

That is why theNEA has launched the #TheRealEczema campaign for Eczema Awareness Month 2019, whose colors are orange and purple. They are asking people with eczema to share their stories on social media using the hashtag,raise funds for research, and register for theNEA's webinar"The Cure," which took place on October 16.

The best way for people to advocate is to share their truth, says Block.

Also, theNEA is promoting the Understanding AD campaign, which follows the life of a 17-year-old with atopic dermatitis and shows his support network in managing the disease. The biotechnology company Regeneron Pharmaceuticals funds the video series, along withdrugmaker Sanofi. It's the maker of Dupixent (dupilumab), an injectable medication for moderate to severe cases that disrupts the immune systems overreaction to atopic dermatitis triggers.

Meanwhile, the AAFA has launched the #ADinAmerica awareness campaign, encouraging people to share facts about the disease all month through social media.

Use the information below to learn more about Eczema Awareness Month activities, how you can use your voice to fight stigma and advocate for better treatments, where you can find morale-boosting support for managing the disease, and how you can donate toward research or even participate in studies related to eczema.

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Eczema Awareness Month 2019 - Everyday Health

They analysed patch-test data dating from 1993 to 2017 from two tertiary referral patch-testing centres including the results of 511 children who presented with suspected skin allergies.

Of those, more than half had a positive patch-test, and 65.8 per cent of those (38 per cent of the total) had a positive patch-test deemed relevant as an allergic reaction to a substance they had been exposed to.

The five most common relevant patch-test reactions were to fragrance mix (a mixture of eight individual fragrances commonly found in perfumes, cosmetics, laundry products and toothpaste), a group of preservatives (MCI/MI and MI) commonly used in wet wipes, liquid soaps, shampoos, cosmetics and toy 'slime', the plant resin colophonium (which commonly causes reactions to adhesive dressings), another fragrance (myroxylon pereriae) found in cosmetics and food, and nickel sulphate.

The study's lead author Claire Felmingham said MI and MCI/MI are particularly "potent allergens" that have been described as causing an "epidemic" of allergic contact dermatitis in adults and should be generally avoided even without a diagnosed allergy.

Dr Felmingham said the preservatives are being gradually removed from a lot of products, but that given their presence in baby wipes and 'slime', "its not surprising that theyve also affected the paediatric population".

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While the study found very few children under five had been patch-tested, among the 6-10 age group, fragrance and colophonium were the most common allergens. Fragrance and nickel sulphate were the most common allergens in the 1117 age group.

Nickel sulphate allergies were more common among girls, which the authors said is consistent with existing literature and likely due to the "increased use of jewellery in females", particularly ear piercings.

Armed with evidence of the most common allergens affecting children, the researchers have proposed the first Australian Paediatric Baseline Series comprising 30 common allergens and potential allergens for patch-testing.

While patch-testing is "the gold standard" for diagnosing allergic contact dermatitis (ACD), it "appears to be performed infrequently in children, and consequently, ACD is likely underdiagnosed," the authors said.

"This is unfortunate because ACD can have a significant impact on a childs quality of life, andearly, correct, identification of allergens and subsequent avoidance can lead to substantial improvement in symptoms, preventing progression to a chronic disease state," the study found.

Dr Felmingham said parents should consider patch-testing their children if they have persistent eczema that isn't responding to treatment, as well as keeping an eye on product labels for ingredients that commonly cause allergies.

Jenny Noyes is a journalist at the Sydney Morning Herald. She was previously a writer and editor at Daily Life.

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Fragrances found in baby wipes and 'slime' among most common causes of skin allergies - Sydney Morning Herald

When the patient was dressed, Iammatteo returned to the examination room. She didnt think this was an allergy, she told him. But it could be a parasite. She thought it was more likely toxocara, given his recent exposures to dogs and cats. Toxocara is a type of parasite called a nematode or roundworm. It lives in the gastrointestinal tract of dogs and cats. Until the end of the 20th century, visceral toxocariasis could be diagnosed only by the symptoms it caused when it invaded the organs of the body the liver, the lungs, the brain or the eyes. These were serious infections causing everything from wheezing and shortness of breath to blindness or, rarely, death. It wasnt until a diagnostic blood test was developed that other manifestations of the disease were identified. In whats called common toxocariasis, patients have gastrointestinal symptoms as well as an itchy rash. In covert toxocariasis, the only symptom is an itchy rash. These infections often resolve on their own over time, but they can also be treated with a medicine. This patient could have covert toxocariasis.

Iammatteo said she would test for both toxocariasis and strongyloidiasis. She would also refer him to a hematologist to look for a malignancy or other trigger that might have caused his overproliferation of white blood cells. There were other causes of his rash and eosinophilia, but these were the most likely and a good place to start.

A few days later, she got a possible answer and called the patient. You probably have toxocariasis, she told him. The blood test came back positive, but she explained there was a caveat. The test measures whether the immune system has responded to this particular parasite ever. The fact that it was positive meant that the patient had been exposed to the parasite, but it couldnt determine when the exposure occurred. Toxocara infections are most common in children. But the test will still be positive even if the infection is long gone. The only way to know for certain that the toxocara was causing the itch, she told him, was to treat him and see how he responded. She referred him to an infectious-disease doctor who prescribed the recommended five days of Albendazole.

Because he couldnt know for sure if this was the right diagnosis, the patient kept his appointment with the hematologist. That doctor sent off more blood to look for signs that the overabundance of these cells could be caused by an eosinophil gone wild.

But well before those tests results came back negative, the patient felt that he had his answer. Within days of completing his treatment with Albendazole, the itching resolved. And by the time he went back to see Iammatteo two weeks later, even the rash had mostly disappeared.

Why had Iammatteo been able to figure this out when other doctors couldnt? the patient asked when he saw her for a follow-up visit. She explained that shed gone to Albert Einstein College of Medicine in the Bronx, and one professor there was an expert in parasitology. She took her class, and what she learned stuck with her. Different medical schools have different strengths, she told me later. Parasites were one of theirs.

And, she added, doctors are taught that toxocara infection is rare. But now shes not so sure. Since making this patients diagnosis last spring, she told me she has diagnosed nearly a dozen cases of toxocariasis in patients whom she might not have thought to test for the parasite if not for this older man and his rash. I know Ive been successfully diagnosing more of it because its on my mind.

Read more:
He Was Unbearably Itchy, but the Problem Wasnt in His Skin - The New York Times

Eczema can be painful and debilitating. Leona ONeill meets three NI families who have learnt how to live with the condition.

Eczema also known as dermatitis is a dry skin condition that can come in many different forms. In mild cases, the skin is dry, scaly, red and itchy while in more severe cases, there may be weeping, crusting and bleeding.

Constant scratching causes the skin to split and bleed and also leaves it open to infection. At its worst, the condition can be very painful.

Dermatitis affects people of all ages but is primarily seen in children one in five children and one in 12 adults live with eczema.

Three Northern Ireland women tell us about their familys experiences and how theyve learned to cope with the condition

Myrtle Johnston, from Belfast, represents the NI Support Network for the National Eczema Society. She joined the society after her son and daughter were both diagnosed with the condition. She says:

I got involved in the National Eczema Society 40 years ago when both my son and daughter had the condition.

My son had it when he was a baby and throughout his school years. My daughter developed it a bit later.

There are people who have experiences that are a lot worse than ours, and I just hope they know they can talk to people about it.

What people dont realise is how eczema can affect a whole family. Children do suffer badly, meaning their parents do, too.

Some children have it really quite bad on their face and I know another mother who was taking off her sons socks and the skin just came off with it.

There are some really heart-breaking stories where people have had to think about giving up their career and lots of other things.

Eczema wont kill you, but it is very disabling.

East Belfast mum Michelle Laverty (48) says her son Henrys eczema left him feeling itchy and uncomfortable and was starting to impact on his confidence, before she found something that worked for him. She says:

My son Henry has eczema on his upper arms. He has had it from he was a little baby and it really came out as he started getting older.

It seems that it had something to do with him getting ready in the morning. The stuff I was using on his hair was coming down over his upper arms and that was causing his eczema.

It had never even occurred to me that could happen. He had raised red spots and it was so itchy and uncomfortable for him.

He would have scratched himself and it looked so red and awful.

Eczema does not have a nice appearance and it really affected his confidence. He was lucky in a way because it was on his upper arms, so it was quite covered most of the time.

I mentioned it to one of the girls in my office and she suggested Elave cream, which she said worked for her child.

Obviously eczema is a huge thing for children and it affects so many.

So, I got the shampoo and the shower gel and within about 10 days it was significantly better. It worked really well.

I nipped it in the bud before it got any worse, because I know how bad some children can suffer with eczema.

Mum-of-three Angela Morgan (42), from Belfast says her daughter Evies (5) eczema was so bad there would be blood on her bed clothes. The Four Winds beauty salon owner says she felt helpless about the condition until she found something that worked for her little girl. She says:

My youngest daughter Evie has eczema, asthma and allergies.

She has had all of those from birth. Since she was very small her skin would be itchy and red, particularly in between the creases of her arms and legs. Then it spread. Her face would be totally broken out. Around her cheeks, the skin was raw and would get quite infected, particularly when she was teething.

It was really hard to manage. She was on all types of creams and antibiotics and steroids. We tried everything but nothing worked.

They thought initially that it was baby eczema, but as she started getting older, nearing a year old, we realised that the likes of strawberries, bananas and tomatoes would have set her skin off.

So by the time she got that little bit older, it was very much tied to food as well.

At its worst, during a really bad flare-up, it would appear all over her.

I remember one day when she was very young, taking her into a cafe before a doctors appointment and people were staring at her because her face was so raw.

She would have just scratched herself until she bled.

Angela says that she tried every cream on the market as well as everything the doctor prescribed, to no avail.

Any time her skin looked in any way dry at all, we plastered her in cream, she says.

She would have scratched herself in the middle of the night, so there would be blood on the bed clothes in the morning. And I felt terrible because there was nothing I could do about it.

The doctors were giving me cream after cream, hoping that something was going to work. And with Evie being so young, I didnt want to resort to antibiotics all the time.

It was a constant battle trying to get to it before it got to the stage where she needed antibiotics.

Evie also lives with asthma and severe allergies, associated with her eczema.

Evie would take an anaphylactic reaction to nuts, pulses, legumes, kiwi and eggs, says Angela.

We knew that she was sensitive to certain things. But at that stage, she hadnt been tested for anything. I just didnt give her any nuts, because I assumed that it probably wouldnt be a good idea.

But I came home one day, and Evie was coughing while sitting on the sofa. I asked my husband how long she had been doing that and he said around half an hour.

I could see her skin also starting to break out, so I picked her up and took her around to the chemist.

They gave her some Periton and told me to take her to the hospital.

She had eaten a peanut M&M and that was the start of it. She had an overnight stay there.

Then, a few weeks later, she had a mouthful of vegetable soup which had lentils in it. And it was the same again her face and lips swelled, and we had to go straight to the hospital where she got adrenaline and all sorts of things.

We have had a few dramas.

We had an issue where someone gave her peanut butter recently and I had to give her the EpiPen and take her to the hospital.

Because Evie is that little bit older, she is more aware of it and has become more vigilant about what she eats now. We dont have anything that could harm her at home and her school were very good they are nut-free. But we have to be very careful and carry an EpiPen and Periton around with us everywhere, just in case.

When she was three years old, we discovered that she was asthmatic as well. She takes inhalers now also.

Angela says that she finally found her miracle cream in the form of Elave skincare.

All the stuff that we got from the doctor just didnt work, she says.

And then I heard about the Elave products and started using them on Evies skin. Her skin has been amazing since.

For the majority of the year as the change in the weather can flare her up she has been really good.

We just keep the cream on the spots that are more likely to flare up.

I use the whole range; the bath wash, the shampoo and the cream with Evie. Using all three works a treat.

I love it because it is a totally natural product, there is nothing harsh in it that can harm her skin. The condition is so easily triggered.

For something as simple as this product is, to be so effective, has been amazing and is working really well for her.

The National Eczema Society confidential telephone and email Helpline provides information, support and reassurance to people struggling to cope with eczema. You can contact the helpline on 0800 089 1122. Myrtle Johnston is also available through the helpline if you want to make contact with support from Northern Ireland

The Gardiner family history of creating skin care products goes back to 1934 when Joseph Gardiner created the first Family Apothecary in Ireland.

Their expertise in making traditional Ovelle apothecary products like Silcocks Base, Aqueous Cream and Emulsifying Ointment allowed them to draw on dermatological advances in skincare to create the now multi-award winning Elave skincare headed up by Josephs granddaughter Joanna which helps prevent flare up of sensitive including eczema, dermatitis and rosacea prone skin.

Their promise of absolute purity means no sulfates SLES/SLS, no parabens, no perfume, no formaldehyde, no methylisothiazolinone (MI), no alcohol, no soap, no colours and more. Elave sensitive skincare has been awarded cruelty-free status by PETA and is also vegan friendly.

Their products are available in most pharmacies and online at http://www.elave.myshopify.com/

Belfast Telegraph

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Meet the Northern Ireland people battling eczema who are finally comfortable in their own skin - Belfast Telegraph

Ann & Robert H. Lurie Children's Hospital of Chicago issued the following announcement on Oct. 16.

In a study using non-invasive tape strips in young children with eczema (or atopic dermatitis), researchers found many molecular signs of immune dysfunction and skin changes that relate to disease activity. These signs (or biomarkers) were present even before eczema was visible and can be used to track disease activity over time. With more research, these biomarkers also may help predict response to medicine and development of conditions associated with eczema, such as asthma, other allergies, infections and even attention deficit hyperactivity disorder (ADHD). Findings were published in JAMA Dermatology

Our study was the most comprehensive to date to demonstrate that tape strips can be used in infants and young children instead of painful biopsies to assess early-onset atopic dermatitis on the molecular level, says senior author Amy Paller, MD, from Ann & Robert H. Lurie Childrens Hospital of Chicago, who also is Chair of Dermatology and Professor of Pediatrics at Northwestern University Feinberg School of Medicine. We found the highest number of atopic dermatitis biomarkers, including new ones, that might be predictors of treatment response, disease progression, and development of comorbid conditions.

Atopic dermatitis is a long-lasting, inflammatory, extremely itchy skin disorder that affects 10-20 percent of children in the United States. Currently, molecular profiling of skin biopsies is the gold standard for evaluating atopic dermatitis.

In young children, skin biopsies are virtually impossible to perform, even in research, since they are painful and leave scars, says Dr. Paller. This reinforced our desire to find a way to evaluate these kids that did not hurt at all.

The study included 51 children younger than 5 years, with 21 children who had moderate to severe atopic dermatitis that had its onset less than six months previously. Tape strips were collected from the skin with and without lesions in the children who had atopic dermatitis, as well as from the normal skin of children who did not have the condition. Researchers evaluated gene expression of 77 biomarkers of immune dysfunction and skin barrier changes (97 percent of biomarkers assessed) in children with atopic dermatitis.

Our findings pave the way for more routine use of tape strips in pediatric longitudinal research and clinical trials for atopic dermatitis, says Dr. Paller. Eventually, we hope this technology will become commercially available for use in the clinic.

Original source can be found here.

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ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO: Painless Tape Strips Used to Detect Molecular Changes in Skin of Children with Eczema -...