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Clinical assessment
Causes & Diagnosis
The core problem is a disrupted skin barrier combined with an overactive immune response. A defect in the filaggrin gene, which helps build the skin's protective outer layer, makes the skin more permeable, allowing moisture to escape and irritants to penetrate. Staphylococcus aureus, which colonises the skin of most people with eczema, plays a significant role in triggering and perpetuating flares.
Common triggers include dry skin, heat, soap and detergents, dust mites and pet dander, stress, and skin infections.
How is it diagnosed?
Diagnosis is primarily clinical, with pattern, distribution, and history forming the basis of assessment. Allergy testing or patch testing may be recommended to identify contributing factors. Distinguishing eczema from psoriasis, contact dermatitis, and seborrhoeic dermatitis is important, as these require different treatments.
