The process of eczema diagnosis involves looking into many details. The doctor begins by conducting a physical examination. Many patients are young children. The doctor looks at the child’s medical history and gathers the family medical history from the parents.
The skin is closely examined for the presence of lesions. The distribution of lesions over the body is another factor the doctor looks at. When doing an eczema diagnosis, he will also ask about the times at which the symptoms appear, to detect any seasonal variations.
There are many environmental factors that can trigger an eczema flare up. They must be taken into consideration for a comprehensive eczema diagnosis. Environmental triggers include pet dander, plastics, dust, nail polish remover, detergents and other household cleaning agents, cosmetics and a variety of chemical agents. Several food items are also known to trigger eczema attacks.
The doctor will probe for a presence of bacterial infections on skin, eye problems and several other conditions that may occur concurrently with eczema.
If the patient is an older child or adolescent, the doctor will ask them for their observations about how their skin rashes and lesions are affected by various factors such as the presence of pets, using certain brands of deodorants, shampoos, perfumes or other cosmetic products. He will also want to know whether their symptoms are affected by prescriptions medications, using fabric softeners, wearing woolen cloths, using fabrics with rough texture and so on. Other factors that go into an eczema diagnosis include changes in disease symptoms at various stages of the menstrual cycle, changes related to hot or cold temperatures, high stress levels, sports or athletic activity, etc.
Unfortunately, there are no laboratories tests that can be used to either confirm or deny the presence of eczema. That is a reason why the doctor will attempt to do a detailed study of the symptoms and possible factors as outlined above. In fact, the doctor may need to see the patient two or more times to confirm the eczema diagnosis, particularly to distinguish between various types of eczema. Doctors usually go by criteria that have been published during the 1990s.
Atopic dermatitis is diagnosed on the basis of four major criteria. The first is the presence of a particular kind of skin lesions accompanied by a characteristic distribution pattern across the body. The second criterion is the presence of pruritus. A history of atopic disorders running in the family or a personal history of such disorders is the third criterion. The fourth one is the presence of recurrent dermatitis or chronic dermatitis.
In addition to the above four criteria, there are over twenty minor criteria for distinguishing atopic dermatitis. Some of the more common ones include intolerance to woolen clothing, onset of symptoms at an early age, type 1 response to certain tests, propensity to get skin infections, dry skin or xerosis, recurrent conjunctivitis, ichthyosis, elevated levels of total serum IgE, intolerance to certain foods, symptoms triggered by emotional stress and so on.
If a child or adolescent displays at least three of the four major criteria and at least three minor criteria, the doctor will usually confirm the presence of atopic dermatitis.
If the child displays acute allergic reactions to foods or if she has asthma, the family practitioner may refer her to an allergist.
In some cases the doctor may ask for blood test to check the levels of IgE in blood serum. Other laboratory test may include analysis of smears from lesions in order to rule out bacterial infections, herpes virus infections, scabies, etc. These infections create symptoms similar to those of eczema and can serve to confuse the eczema diagnosis process.
In cases of severe eczema, the doctor may ask for skin prick testing to find out if specific food items or other substances trigger eczema attacks. This test is done by pricking he skin surface with a needle o insert a small quantity of the substance in question.
Eczema diagnosis can be an involved process. It is important to go through the process diligently in order to obtain a correct diagnosis.