Q. I have an itchy skin which is driving me mad. The itching is more around my joints such as the knees and elbows. I went to the doctor a couple of weeks ago as I had also developed a rash on my legs and arms. He said it was urticaria. I am worrying myself sick as I read that itching could also be a sign of lymphoma. I was taking Piriton, which seemed to help. I also hear that it could be stress related, and I have had a fair bit of that recently, including insomnia. Could you please advise as to what this might be and what would be the other signs if it is a serious problem?
A. It seems you could be suffering from atopic eczema. Of course, it needs to be checked by your dermatologist. It usually occurs in people who have an atopic tendency. This means they may develop any or all of three closely linked conditions: atopic dermatitis, asthma and hay fever (allergic rhinitis). Any area such as the bends of the elbows, backs of the knees, ankles, wrists, face, neck and upper chest may be affected. When it appears on the palms, back of the hands, fingers, or on the feet, there can be episodes of crusting and oozing. The intense, almost unbearable itching can continue, and may be most noticeable at night. Some patients scratch the skin until it bleeds and crusts. When this occurs, the skin can get infected. The following factors may cause an exacerbation of atopic dermatitis:
• Dry skin
• Cold, damp climate
• Treatment: Reduce exposure to trigger factors (where possible)
• Regular use of moisturizers
• Intermittent topical steroids
In some cases, management may also include one or more of the following:
• Topical calcineurin inhibitors such as pimicrolimus cream or tacrolimus ointment
• Oral corticosteroids etc.