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ECZEMAPEDIA
KERATOSIS PILARIS (“CHICKEN SKIN”)

Keratosis pilaris (KP) yang juga dikenali sebagai “chicken skin” merupakan keadaan kulit yg lazim berlaku. Biji-biji yang kelihatan seperti jerawat ini sebenarnya adalah sel kulit yang mati yang menyumbat folikel rambut. Jerawat ini boleh berwarna merah atau perang. Ia biasanya wujud di bhg atas lengan, peha, pipi atau punggung. Ia tidak berjangkit dan biasanya tidak gatal dan tidak menyebabkan sebarang masalah. KP boleh bertambah teruk apabila cuaca kering dan bila kulit kering. Ia juga boleh bertambah teruk semasa mengandung.

KP adalah penyakit kulit yang ada kaitan genetik dan tidak mempunyai rawatan tertentu . Ia biasanya akan hilang secara sendiri bila seseorang mencapai umur 30an.

SYMPTOM KP

Simptom utama KP adalah biji biji yang timbul yang menyerupai seperti kulit ayam yg telah dicabut bulunya. Ia boleh timbul di mana folikel rambut wujud. Oleh itu, KP tidak akan timbul di kawasan tapak tangan dan tapak kaki. Ia lebih kerap berlaku di bhg atas lengan dan peha. Ia boleh juga timbul di bhg kaki dan tangan yang lain. Simptom yang lain adalah:

    1. warna merah sekeliling biji tersebut
    2. Kulit yang rasa gatal
    3. Kulit yang kering
    4. Biji biji yang timbul yang rasa seperti kertas pasir
    5. Biji tersebut boleh mempunyai warna yg berbeza bergantung pada warna kulit (putih, merah, merah jambu, hitam atau perang)
PENYEBAB KP

Keadaan kulit yang benign ini adalah disebabkan oleh pengumpulan keratin iaitu sejenis protein rambut di dalam liang roma. Jika anda mempunyai KP, ini bermakna keratin rambut anda telah menyumbat liang pori rambut. Akibatnya, biji biji kecil yang timbul wujud di bhg di mana rambut sepatutnya wujud. Jika anda menggaru biji tersebut, anda mungkin dapat melihat rambut yang hauls di bhg bawah biji tersebut.

Penyebab pengumpulan keratin ini masih tidak diketahui, tapi ada pakar yang berpendapat ianya ada kaitan dengan penyakit kulit yg lain seperti atopic dermatitis (eksema) dan penyakit genetik yg lain.

SIAPA YANG BOLEH MENDAPAT KP?

Ia lazim berlaku pada mereka yang mempunyai:

    1. kulit kering
    2. Eksema
    3. Ichytosis
    4. Resdung
    5. Melanoma
    6. Obese
    7. Wanita
    8. Kanak-kanak atau remaja

 

KP lebih kerap berlaku pada kanak-kanak dan remaja dan biasanya akan hilang semaa pertengahan umur 20an dan dalam kebanyakan kes, hilang sepenuhnya semasa umur 30an. Perubahan hormon semasa mengandung atau semasa mencapai baligh boleh menyebabkan KP bertambah teruk. KP lebih lazim berlaku pada mereka yang mempunyai kulit yg cerah.

CARA RAWATAN

Tidak ada ubat yg boleh menyembuhkan KP dan biasanya tidak banyak rawatan yang boleh membaiki keadaannya. Antara teknik yang boleh dipakai adalah:

    1. Memakai pelembap untuk mengelakkan kulit menjadi kering. Pelembap yang mengandungi urea dan asid laktik adalah sesuai utk mengeluarkan sel kulit yg mati dan menghalang folikel rambut dari tersumbat.
    2. Microdermabrasion
    3. Chemical peels
    4. Krim retinol

Ramuan dalam krim diatas boleh menyebabkan iritasi dan rasa pedih dan boleh mengeringkan kulit, oleh itu, ia mestilh dipakai selepas mendapat nasihat pakar kulit.

RAWATAN RUMAH

Anda juga boleh mencuba teknik-teknik ini di rumah spt:

    1. Mandian dengan air suam untuk jangka pendek untuk melembutkan liang pori yg tersumbat dan berus dengan berus lembut di bhg biji tersebut. Proses ini mesti dilakukan utk jangka pendek kerana ia boleh mengeringkan kulit juga.
    2. “Exfoliation” (pengeluaran sel kulit mati) boleh dilakukan dengan kerap menggunakan loofah atau batu pumis.
    3. Mengguna kan minyak kelapa sebagai bes untuk sugar scrub untuk mengeluarkan sel kulit mati dan meredakan kulit yg merah dan radang.
    4. Elak dari memakai pakaian yg ketat
    5. Guna humidifier di rumah supaya udara di bilik tidak kering

 

          

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Recently, I received many messages from mothers with eczema children asking if they should vaccinate their children. The worry is understandable as eczema involves the child’s immune system and mothers worry that vaccinations can somehow damage their child’s immunity. Claims from other parents about their child getting eczema after immunization also adds to the scare.

I just want to emphasize again that vaccines (including MMR) do not cause eczema.

There are some cases in certain children, although quite rare, where their eczema flared up after vaccination. Doctors or pediatrician giving the vaccination to an eczema child should warn parents of this possibility. Children who have a severe allergy to egg can be given the MMR vaccine as the attenuated MMR viruses are grown on cultures of chick embryo fibroblasts and not on egg white or yolk. If you do have concerns about your child’s egg allergy, do talk to your doctor about this.

There are many different studies that have been conducted studying the link between vaccines and eczema and I will not go into detail into these. One should be able to get this information from the many scientific papers published and reviewed on this subject matter. To date, there is no conclusive evidence that supports the link between vaccines and eczema.

In my opinion, by choosing not to vaccinate your eczema child, you are leaving her vulnerable to diseases. As I see it, vaccination isn’t an all or nothing decision. Should your child have severe allergic or eczema conditions, you can opt to delay vaccinating your child until his condition has stabilized.

As a mother of an eczema child myself, I get very distressed when I hear of other parents advocating other parents not to vaccinate as well based on their false belief that vaccinations cause eczema or exacerbate the eczema conditions.

When this happens, it leaves our young children, the elderly and the immunocompromised to become vulnerable to infectious diseases, which can cause severe complications and even fatalities.

I strongly believe that vaccines play a critical role in limiting or eradicating many very serious infectious diseases. As parents, it is our responsibility to protect our children from these vaccine-preventable diseases. So, let us make the decision to vaccinate based on rational reasoning and not based on fear and false beliefs.

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People with eczema should take special care with the items that come into direct contact with their skin. In addition to the fabrics themselves, the products you use to care for them can potentially cause a reaction with your skin. Dyes, perfumes, fragrances, and detergents that are left on the fabric after washing and drying may irritate sensitive skin, so avoid them.

What to look for in laundry care products

For most people fragrances (perfumes), dyes, and detergents are what cause skin reactions. For some people, almost any brand of detergent that is free of dyes and fragrances will be satisfactory as long as the laundry is rinsed adequately. Some people have additional allergies, which can make even a detergent without dyes and perfumes problematic. It may take some trial and error to find a detergent that works for you.

    • Choose products (from detergents to fabric softeners) that are hypoallergenic, free of dyes and fragrances, and formulated for sensitive skin.
    • Try liquid products, as they tend to leave fewer residues than powders.
    • Consider using a liquid fabric softener. Studies have shown that clothes treated with fabric softener have a potential benefit for people with sensitive skin.
    • Use your washing machine’s second or “extra rinse” setting if it has one.
    • Check the NEA website for laundry products that have been awarded the NEA Seal of Acceptance

Wash new fabrics before first use

New clothing can sometimes have a finish on it to make it more appealing at the store.

    • Wash new clothing, bedding, and cloth napkins before you use them.
    • Wash everything your baby comes into contact with (plush toys, bedding, blankets, parent and caregiver clothes, towels) before being used for the first time.
    • Consider washing the clothes, bedding, and towels of the person with sensitive skin separately.

Laundry room safety

If you have children, pay special attention to how you use and store laundry care products.

    • Keep laundry products in their original containers with the original label intact.
    • Place products in a secure location after use, out of the reach of children and pets. Consider storing them in a high, locked cabinet. Do not store products on top of the washer or dryer.
    • Keep single-use detergent laundry packets away from children. These packs are very concentrated and should never be handled or played with by children. The packs dissolve quickly when in contact with water, wet hands, or saliva.
    • Throw away empty product containers properly. Do not reuse detergent buckets or bottles for other uses.
    • Clean up any spills, and immediately wash your hands and any items you use to pour or measure products.
    • Close and lock the laundry room door when you are finished, so curious young children cannot get in.
    • Pay special attention to spray bottles. They are a common source of exposure to cleaning solutions and should be kept out of a child’s reach.

 


Laundry Room Safety information reproduced with permission from the American Academy of Pediatrics and healthychildren.org

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Why is bathing so effective?

When your skin is dry, it’s not because it doesn’t contain enough oil. It’s because your skin isn’t doing a very good job of retaining its moisture (water). Wind, low humidity, cold temperatures, harsh soaps and too much washing without the use of a moisturizer can lead to dry skin, which can irritate your eczema and even make it worse.

People with eczema, especially atopic dermatitis, tend to have very dry skin in general. This is because the disease causes defects in the skin barrier. The skin barrier is uppermost layer of skin that protects irritants, bacteria/viruses, and allergens from getting into our bodies and moisture from getting out. Genes, skin trauma such as from scratching or rubbing, and inflammation can all contribute to this defective or “leaky” skin barrier in people with eczema.

The most effective way to treat dry skin is to give it the moisture it needs. Proper bathing and moisturizing are important for this reason — especially if you have eczema. The best way to replace moisture in the skin is to soak in a bath or take a shower and then moisturize immediately afterward.

Soak and Seal

The “Soak and Seal” method of treating eczema is recommended by many providers to combat dry skin and reduce flares. To get the full therapeutic benefit, Soak and Seal often and follow these steps in order.

Instructions to Soak and Seal:

    1. Take a bath using lukewarm (not hot) water for five to 10 minutes. Use a gentle cleanser (no soaps) and avoid scrubbing the affected skin.
    2. After bathing, pat the skin lightly with a towel leaving it slightly damp.
    3. Apply the prescription topical medication to the affected areas of skin as directed.
    4. Within three minutes, liberally apply a moisturizer all over the body. It’s important to apply the moisturizer within three minutes or the skin may become even drier.
    5. Wait a few minutes to let the moisturizer absorb into the skin before dressing or applying wet wraps.

Tips for bathing and moisturizing with eczema

Some things to remember when bathing:

    • Take at least one bath or shower a day
    • Bathe or shower in lukewarm (not hot) water for 10 to 15 minutes
    • Avoid scrubbing your skin with a washcloth or loofah
    • Use a gentle cleanser (not soap)
    • During severe flares, limit the use of cleansers to further avoid irritation

Some things to remember when moisturizing:

  • Use a high-oil content moisturizer twice a day to improve hydration and protect the skin barrier
  • Moisturize hands every time you wash them or they come into contact with water
  • Schedule your bathing and moisturizing routine at night, just before bed. This can help your skin better retain its moisture
  • If you have eczema on your hands, soak your hands in water, then follow with an application of your prescription medication (if you use one) and moisturizer. Wear cotton gloves over your hands while you sleep to help “lock-in” the moisturizer
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