Eczema is not a condition but a group of skin diseases that causes skin
inflammation and irritation. It exists in several different forms, and each form has its
signs and symptoms. Eczema is also referred to as Atopic dermatitis (AD), which is its
most prevalent and popular form, with a high global burden in morbidity and healthcare costs. It is a chronic recurrent skin inflammatory disorder that is characterized by
itching, redness, burning sensation of dark or light patches, papular bumps and weeping
or crusting eruptions of the skin. Pathophysiology of AD is complex and multifactorial,
involving genetic predisposition, skin barrier defects, immunological dysfunction and
regulation, microbial colonisation, neuroinflammation, altered lipid composition, food
allergies and other environmental risk factors. Currently, available treatment regimens,
which include corticosteroids, calcineurin inhibitors, antibiotics, immunomodulatory
agents, UV therapy, may offer some relief to patients, but there is no permanent cure
for the disease. Specific cases may additionally need psychosomatic counselling (in
stress induces exacerbations), Monoclonal antibodies targeting T-helper 2 pathways
and aeroallergens, which may improve the condition of associated asthma or rhinitis.
To minimize the side-effects caused by conventional treatments such as skin atrophy,
telangiectasia, lymphomas and malignancies, Novel jakus kinase (JAK) receptor
inhibitors are under development which are believed to show promising effects in
treating AD. Traditional Chinese herbs, used widely, have revealed some
supplementary activity in reducing the severity of AD. Tapinarof, a naturally derived
stilbene that activates aryl hydro carbon receptor (AHR) and triggers inflammation, has
shown significant results in AD and psoriasis patients. Homeopathy, aroma therapy,
essential oils, essential fatty acids, vitamins and minerals, have also been exemplified
to aid clinical AD treatment.
Keywords: Atopic dermatitis, Calcineurin inhibitors, Corticosteroids, Cutaneous microbiome, Dupilumab, EASI, Eczema, Filaggrin, Immune dysregulation, JAK receptor inhibitors, Monoclonal antibodies, Phototherapy, SCORAD, Traditional herbs
