Learning What Kind of Eczema you Have, What Triggered it for Best Treatment and Management [Interview][Transcript]

amy_paller_pediatric_eczemaGuest: Amy Paller
Presenter: Neal Howard
Guest Bio: Amy S. Paller, MD serves as the Walter J. Hamlin Professor and Chair of Dermatology and Professor of Pediatrics at Northwestern University’s Feinberg School of Medicine. Dr. Paller is a recognized researcher, author, and editor in the field of dermatology, with more than 350 publications to her name. She is an author of Hurwitz Clinical Pediatric Dermatology: A Textbook of Skin Disorders of Childhood and Adolescence, 5th Edition.

Segment overview: Amy Paller, MD, Professor of Pediatrics at Northwestern University’s Feinberg School of Medicine, discusses a new survey issued by the National Eczema Association (NEA).

Health Professional Radio – Learning about Eczema

Neal Howard: Hello and welcome to Health Professional, I’m your host Neal Howard for this Health Supplier Segment. Thank you for joining us today. Our guest in studio is Dr. Amy Paller, Professor of Pediatrics at Northwestern University’s Feinberg School of Medicine also the Walter J. Hamlin Professor and Chair of Dermatology. She’s here today to talk about pediatric eczema and it’s far reaching impact. Welcome to the show Dr. Paller.

Dr. Amy Paller: Thank you.

N: What exactly is eczema and does eczema differ in children as in adults?

P: Well eczema is the late term for a disorder that doctors would call atopic dermatitis and it’s an inflammatory skin condition that’s really quite common in this country. In fact a much more common in children than it is in adults affecting about 10 to 20% of kids and maybe up to 10% adults. It differs in kids versus adults in terms of some of the distribution and certainly sometimes some of the responses but in either group it can have a profound effect on quality of life.

N: Now when you say that it is a very common, is it contagious?

P: No, fortunately it’s not contagious but it’s common in that primarily a childhood disorder. About 90% have early onset in the first five years of life and about half in the first year of life so this really has its start for most affected individuals quite early on.

N: Is eczema something as you say that starts in kids, can a child grow out of it or once you have it are you automatically going to have to be treated for it medically?

P: That’s a great question. Yes there might be a question about what does ‘outgrown’ mean because I really think that if you have a tendency towards this, you may have skin that’s more sensitive throughout life. For example we’ll see a lot of kids who may not have the same manifestations later on but had hand eczema as adults. However even though the data are all over the place many children, especially children who are milder do tend to outgrow it – that is don’t have it later on in life.

N: When kids are interacting with each other, you talked about some of the distributions, how it’s transmitted throughout the body. Does a kid’s lifestyle contribute to the spread of eczema throughout the body?

P: Well certainly eczema can vary from child to child. There are some children who have very limited involvement. For example just in the folds of the arms or the folds of the legs and then there are other children who have it over every inch of their body. This is a very itchy problem and when you’re itchy, think of a mosquito bite and how you can dig at that, imagine having that sense over large areas of your body. It’s incredibly uncomfortable and disrupts sleep, not only for the child but for the entire family. So it’s hard to know what triggers are, we just know that things like irritants, that infections and for some children even allergic triggers can make the eczema come out more and be more problematic.

N: Now kids normally go to school how the child able to navigate the school system especially with kids being kids with something as severe as being all over the skin or in certain sensitive parts of the body making it well impossible to sit still?

P: That’s exactly right. Many children who have moderate to severe disease first of all have highly visible skin changes and that makes them subject to having other children to notice and think of them as different. And then on top of that if you can’t sleep, you’re gonna be drifting off in school, you’re gonna have issues with inattention, you’re going to have issues with just being able to participate in the classroom. And then on top of that, children with atopic dermatitis or eczema have red skin that becomes even itchier if it gets hotter. So participations supports the problem not just because they have to wear outfits that sometimes show all of these but little so because sweating and heat makes them that much more itchy and that makes it all that much more unbearable. And then of course there’s the whole stigma issue that other children see them as different.

N: Now a recent survey was conducted by the National Eczema Association and I’m sure they’d touched on many of the points that you’ve discussed here but let’s talk about as I said before kids being kids and quality of life not just where it pertains to the itching and maybe the lack of ability to participate in some types of sports but what about the bullying aspect? Bullying is such a huge issue now when a child is viewed as different first of all and then as someone to be I guess ostracized secondly. How do parents and teachers deal with this especially trying to get the child to deal with it?

P: Yeah, you’re absolutely right. So the National Eczema Association just conducted a survey and they found that one in five children in a survey of almost five hundred parents or caregivers were bullied at school this year because of their disease and that really makes it even harder for these children. We talked about bullying all the time and the impact and getting teachers involved, getting parents involved in helping these kids to learn how to deal with bullying but on top of all these other problems to be bullied in a more than a fifth of children was really eye opening.

N: Let’s talk to parents, teachers and health care professionals, pediatric practitioners out there, what do you tell them in just a few words in order to well help each other when it comes to dealing with pediatric eczema?

P: Well given the results of this NEA survey I think it’s really important that we advise them to educate about eczema and the effects of a children know that there’s a reason that this other child is being bullied is suffering and just try to help these children deal with the stress. So that’s very important for other children to be aware, for teachers to be engaged, for parents to be engaged in reducing the stress for these children.

N: And where can our listeners go and learn more about the National Eczema Association and the results of this recent survey?

P: Well go online because NEA offers a valuable resource for parents and educators to better understand these types of behaviors. On their website at www.nationaleczema.org and look in for particular for eczema tools for school guides to try to provide advice on how to foster a more positive experience for kids with eczema.

N: You’ve been listening to Health Professional Radio, I’m your host Neal Howard for this Health Supplier Segment in studio with Dr. Amy Paller, Professor of Pediatrics at Northwestern University’s Feinberg School of Medicine. Transcripts and audio of this program are available at healthprofessionalradio.com.au and also at hpr.fm and you can subscribe to this podcast on iTunes.

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