Eczema
Eczema is what Chinese medicine calls it, and Western medicine calls it atopic dermatitis.
Due to congenital skin structure problems, the surface cells of patients with atopic dermatitis tend to fall off, losing their natural protective functions, reducing the skin's resistance, and making them susceptible to bacterial infection. Also, because the water on the surface of the patient's skin evaporates more easily, generally speaking, the skin of patients with atopic dermatitis will be dry and even cracked. Therefore, external substances (such as chemicals, allergens) will penetrate into the patient's skin and stimulate the skin's immune cells for a long time, causing skin allergies.
People with eczema may have psychological sequelae. Taking eczema in children as an example, the inflamed areas on their faces will be red and swollen, affecting their appearance. They may be teased and bullied by other students. If the situation persists, eczema patients will lose their self-confidence;
besides,
Dermatitis-affected areas are very itchy and get worse at night, which will affect the patient's sleep quality and make them unable to concentrate when studying. This not only causes academic problems, but also makes the patient emotionally irritable and impatient.
What Are Eczema Symptoms?
- Itchy and dry skin
- Redness and swelling
- Crack
- Damage (due to long-term itching)
- thickening of skin
What Are the Causes of Eczema?
Overall, patients with eczema are more likely to suffer from nasal allergies, asthma and food allergies at the same time than the general population.
Eczema is mainly divided into:
- atopic dermatitis
- contact dermatitis
From the skin surface tissue examination of the above two types of dermatitis, there is not much difference. The difference lies in their eczema-inducing factors that ultimately lead to eczema-prone skin reactions.
| Eczema Category | Predisposing factors |
|---|---|
| atopic dermatitis | Environmental and food allergens |
| contact dermatitis | Chemical substances in direct contact with skin |
Newborn babies with congenital skin structural problems and whose immune systems are often stimulated by environmental substances may easily develop allergies, such as food allergies. Milk and eggs are the most common allergic foods. However, babies with eczema may also be at potential risk before eating the food they are allergic to, and once they eat the food they are allergic to, the condition will worsen.
Generally, food allergies in babies will disappear on their own after a period of time. But when they grow up to two to three years old, they often develop allergies to environmental allergens, such as mite. In Hong Kong, because dust mites There are many cases of eczema. They can stimulate the patient's skin immune system, produce allergic antibody reactions, and cause skin inflammation. dust mites Allergens contain enzymes that help penetrate the skin's surface, making them a very effective allergen.
Apart from mite, the most common allergenic substances are rubber materials, skin care products, soaps, spices, pigments, preservatives, etc. In addition, air humidity, temperature, and chlorine in swimming pools can also affect allergic dermatitis.
Staphylococcus Aureus
Bacterial infection is another important factor leading to allergic dermatitis. As mentioned earlier, patients with eczema have poor skin resistance and are susceptible to bacterial infection, causing skin inflammation.
Common viruses include warts and herpes, which are more severe in people with eczema than in normal people. Staphylococcus aureus is a relatively serious bacterium that is easily found in human skin. Once a patient comes into contact with it, it will breed on the skin and hide in the patient's body. Over time, patients develop allergic reactions to the bacteria, eventually leading to severe allergic dermatitis. Staphylococcus aureus can be transmitted from person to person, and can also be transmitted through clothing, towels, bed sheets, fitness equipment, etc.
Allergy Test
Everyone's allergens are different. Even if you try your best to avoid them, the effect is not obvious. This may be because you are avoiding the wrong "target". Therefore, through allergy testing to find out the allergens that cause your allergies, you can solve the problems caused by allergies at the source.
For allergy testing to successfully identify allergens, the quality of the allergen is crucial because it needs to be compared directly with antibodies in the blood to find the culprit. If the quality is poor, it may lead to ambiguous test results.There are currently less than five companies in the world (CAAM, ThermoFisher, ALK, Chemotechnique, DST) High quality allergens are available for testing.
Europe was the first continent to start allergen testing. At the same time, its development has reached a mature stage. They have similar allergy diagnosis and treatment. They publish and lecture at international academic conferences. Through collaborative research and mutual exchange of practices, the scientific research results have reached maturity and there is enough market to sustain research and development.
History and Development of Allergy Testing
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Developed in 1970-First generation allergy testing
First-generation allergy blood tests combined allergen extracts with a solid, then added to the patient's serum and measured with radioactively labeled anti-IgE antibodies. This radioallergen adsorption test involves hazardous radioactive materials and can only be conducted in specially equipped laboratories.
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Discovered since 1983-There are allergen molecules in human blood
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Since 1990-Second generation allergy testing
Second-generation allergy blood tests use a non-radiative measurement method to test for anti-IgE antibodies. The amount of anti-IgE antibodies can be determined by measuring the degree of color change or the intensity of fluorescence. The test results are affected by the medications you take, and there are fewer types of allergens that can be detected. In addition, people with eczema are prone to false positive results, thus greatly reducing its accuracy.
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2004: 29 kinds of allergen molecules
2005: 74 allergen molecules
2011: 112 kinds of allergen molecules
2016: FABER 244 allergen molecules, more than 150 allergens (the latest generation of IgE allergy test Faber was born in the CAAM research and development laboratory)The Italian CAAM scientific research team, allergists, laboratory technicians and researchers have made further breakthroughs to improve the shortcomings of second-generation allergy testing. The latest developments include the use of molecular allergens to improve accuracy. After 18 years of research, the CAAM research team has published more than 240 academic documents.
Using breakthrough allergen molecular technology to screen out non-allergenic molecular proteins, it can detect more than 95% of screened avoidable allergens (i.e. 244 allergen molecules), greatly reducing false positive test results, and is not affected by medication. It is quite comprehensive and sufficient for allergy patients to find the source of allergy.
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Coming
Soon2030-2035
Allergy test Epitope is expected to be developed and launched in the next 10-15 years.
What Is the Latest Generation of Allergen Molecular Allergy Testing?
With more than 150 allergens, nearly 95% of allergens that can cause allergic reactions are screened, including food and environmental factors, providing a more comprehensive and complete database for allergy patients.
In addition, the latest generation of technology cannot be carried out locally. In addition to the use of instruments for testing, it also requires experts to conduct molecular allergy analysis, and these experts are concentrated in Italian universities.
With the improvement of testing technology, only 3 ml of blood is needed to collect samples, which is more suitable and convenient for newborn babies and children.
What Is a Useless Allergy Test?
Patients with atopic dermatitis generally have extremely high levels of total IgE in their blood, so second-generation food allergy blood tests can have up to 50% false-positive reactions. In recent years, some unproven IgG or claiming to be the fourth generation ALEX IgE allergy testing method has appeared, claiming to be able to measure more than 100 foods at the same time, but the results are questionable. Therefore, food allergy must be diagnosed through provocation testing, otherwise unreasonable abstinence from food may cause physical and mental damage.
Bacterial Infection Test
Check whether the patient has signs of bacterial infection. A part of the bacteria on the patient's skin surface at the time of illness is cultured to test whether it is resistant to antibiotics. If the patient's antibiotic dose is insufficient, it can only remove some of the bacteria, and those that survive will use genetic transformation and other methods to develop resistance to protect themselves in order to survive. Therefore, extra care must be taken when antibiotics are used again.
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What Treats Eczema?
The first and most important step in treatment is skin care. The most basic problem of allergic dermatitis is that the patient's skin structure is defective. Therefore, it is best to use skin care products that can enhance the skin barrier function, such as oil-based skin creams.
In addition, patients should try to use soap-free body wash to reduce the problem of dry skin caused by excessive washing of skin oils. Also, when the skin is dry, moisturizing must be strengthened. The most effective method of moisturizing is taking a bath. It is recommended that patients soak in warm water for 15-20 minutes and apply oily skin care products immediately after bathing to lock moisture in the skin.
If the patient is frequently infected by Staphylococcus aureus, it is recommended that you use a bath gel with bactericidal function.
Eczema Medication Treatment
Antibiotics can treat skin infections, but atopic dermatitis requires steroid medications.
Steroids can effectively reduce inflammation, but some studies have found thatSteroids will worsen the patient's skin protective function. When allergic dermatitis occurs, steroids can reduce inflammation, but long-term use will cause the patient's skin protective function to be impaired.
Other Side Effects of Steroids:
- skin atrophy
- thinning of skin
- vascular plaques appear
- Rebound dermatitis
When the skin has been inflamed for a long time, applying steroid drugs on the surface of the skin may not be able to treat the deep-seated inflammation. At this time, you can useWet wrap treatmentReach anti-inflammatory effect.
Steroid Ointments Are Not Suitable for Long-term Use.
Currently, non-steroidal ointments made from anti-rejection immune drugs are available on the market, which can also achieve anti-inflammatory effects but avoid the side effects of steroids. They are safer drugs for treating allergic dermatitis. Despite this, non-steroidal ointments are not as effective as steroids, so they can only be used for prevention. When the patient's dermatitis has been controlled by steroids, non-steroidal ointments can be used preventively.
Patients with severe allergic dermatitis, it is difficult to control the condition with topical drugs alone. Generally speaking, their immune systems are already extremely allergic, and the IgE antibodies in their blood are quite high. If topical medications are ineffective, oral medication must be used.
Steroids are effective in reducing dermatitis, but as mentioned earlier, steroids are not suitable for long-term use. For those with severe allergic dermatitis, oral steroids can be taken briefly to control the condition. However, a rebound may occur after stopping the medication, and it may be necessary to replace it with alternative immune drugs.
The following are two alternative immune drugs that have more medical data support:
- Azathioprine
- Cyclosporine
Azathioprine is more suitable for children. Its effect is slightly slower, usually taking effect in 8-12 weeks. It can be used together with steroids initially. When Azathioprine begins to take effect, steroids will be discontinued. Generally speaking, Azathioprine has achieved 70%-80% efficacy when taken for 6-12 months. If the patient continues to take it for a longer period of time (about 1-2 years) and the disease is under control, he or she can switch to topical steroids.
Cyclosporine is an anti-rejection drug that usually takes 1-2 weeks to exert its effects. However, Cyclosporine is not only expensive, but also has many side effects, such as affecting kidney function, blood pressure, etc., and there may also be a rebound phenomenon when discontinuation of use.
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What Is Desensitization Treatment?
After taking the allergy test, you know your allergy "black hand", can you be safe by avoiding it? If the allergen is food, such as peanuts, shrimps, potatoes, etc., you can start from the aspect of eating and just stop eating; but if it is an environmental allergen, such as: dust mites, cat and dog dander, etc., even if you try to avoid them, allergic symptoms may still appear from time to time. in dust mites It is the most common allergen in Asia. If you want to permanently "tail-cut" your allergic symptoms, you can receive desensitization treatment, especially for young patients or those who keep cats and dogs.
Desensitization therapy is well-founded; An important treatment certified by the World Allergy Organization to effectively cure allergies. One of the old companies, ALK, has a history of nearly 100 years. The treatment method is like injecting a flu vaccine. A desensitizing vaccine is injected into the patient's body to improve the patient's immunity or produce immune antibodies. When encountering the same allergen again, it will no longer attack the body and reduce allergic reactions.
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Therefore, as long as you know what you are allergic to, you can prescribe the right medicine. Some standardized or very small amounts of allergens are made into sealed tubes, similar in appearance to artificial tears. Taking them daily can enhance the patient's immunity. In the long run, the allergens will become friends and reduce allergic reactions.
For desensitization solutions to be effective, patients must first understand all the factors that cause allergies, such as what causes allergies. With the advancement of science and technology, the latest generation of allergen molecule allergy tests can screen out 95% of food and environmental allergens that cause allergies. Therefore, it is very important to find out which allergens a patient is sensitive to and cooperate with clinical diagnosis.
If the patient only has a single allergen, a single sublingual oral desensitization immunotherapy is very effective; for example, the patient only has a single allergen. dust mites Allergies lead to allergic rhinitis and allergic asthma. Through treatment, the success rate of desensitization can reach 95%. After taking the desensitization solution for 6 to 9 months, patients no longer need to use drugs to control allergic symptoms, effectively helping patients to "cut their tail". Taking it continuously for 3 years can strengthen immunity and achieve desensitization effect.
However, if the patient is allergic to multiple allergens, the difficulty of desensitization treatment will increase. A single sublingual desensitization solution may not be effective, and injections may be required for training. In addition to increasing costs, some allergens may not be removed.
Similar to allergy testing, the quality of desensitization solutions is also crucial, and only three companies in the world are approved for sale. The latest treatment method is sublingual desensitization immunotherapy. Patients need to put the allergen-containing solution under the tongue every day, and it can be absorbed into the mucous membrane of lymphocytes. It can be taken at home without going to the hospital. The oral solution does not need to be refrigerated, as long as it is kept at room temperature, it is very easy to handle.
Hong Kong has more than 30 years of clinical experience in desensitization treatment, and Europe and the United States and other countries have more than 50 years of experience, so the control of desensitization effects has reached an ideal stage.
