Pruritus is a common manifestation of dermatologic diseases, including xerotic eczema, atopic dermatitis, and allergic contact dermatitis. Effective treatment of pruritus can prevent scratch-induced complications such as lichen simplex chronicus and impetigo. Patients, particularly elderly adults, with severe pruritus that does not respond to conservative therapy should be evaluated for an underlying systemic disease. Causes of systemic pruritus include uremia, cholestasis, polycythemia vera, Hodgkin's lymphoma, hyperthyroidism, and human immunodeficiency virus (HIV) infection. Skin scraping, biopsy, or culture may be indicated if skin lesions are present. Diagnostic testing is directed by the clinical evaluation and may include a complete blood count and measurement of thyroid-stimulating hormone, serum bilirubin, alkaline phosphatase, serum creatinine, and blood urea nitrogen levels. Chest radiography and testing for HIV infection may be indicated in some patients. Management of nonspecific pruritus is directed mostly at preventing xerosis. Management of disease-specific pruritus has been established for certain systemic conditions, including uremia and cholestasis.

Eczema is a general term for many types of skin inflammation, also known as dermatitis. The most common form of eczema is atopic dermatitis (some people use these two terms interchangeably). Several other forms have very similar symptoms. However, there are many different forms of eczema. Eczema can affect people of any age, although the condition is most common in infants. Eczema will permanently resolve by age three in about half of affected infants. In others, the condition tends to recur throughout life. People with eczema often have a family history of the condition or a family history of other allergic conditions, such as asthma or hay fever. Up to 20% of children and 1-2% of adults are believed to have eczema. Doctors do not know the exact cause of eczema, but an abnormal function of the immune system is believed to be a factor. Some forms of eczema can be triggered by substances that come in contact with the skin, such as soaps, cosmetics, clothing, detergents, jewelry, or sweat. Environmental allergens (substances that cause allergic reactions) may also cause outbreaks of eczema. Changes in the weather, or even psychological stress for some people lead to outbreaks of eczema. Eczema most commonly causes dry, reddened skin that itches or burns, although the appearance of eczema varies from person to person and varies according to the specific type of eczema. Intense itching is generally the first symptom in most persons with eczema. Sometimes, eczema may lead to blisters and oozing lesions, but eczema can also result in dry and scaly skin. Repeated scratching may lead to thickened, crusty skin. While any region of the body may be affected by eczema, in children and adults, eczema typically occurs on the face, neck, and the insides of the elbows, knees, and ankles. In infants, eczema typically occurs on the forehead, cheeks, forearms, legs, scalp, and neck.

The diverse types of eczema are listed and briefly described below:

• Atopic dermatitis: a chronic skin disease characterized by itchy, inflamed skin
• Contact eczema: a localized reaction that includes redness, itching, and burning where the skin has come into contact with an allergen (an allergy-causing substance) or with an irritant such as an acid, a cleaning agent, or other chemical
• Allergic contact eczema: a red, itchy, weepy reaction where the skin has come into contact with a substance that the immune system recognizes as foreign, such as poison ivy or certain preservatives in creams and lotions
• Seborrheic eczema: a form of skin inflammation of unknown cause that presents as yellowish, oily, scaly patches of skin on the scalp, face, and occasionally other parts of the body
• Nummular eczema: coin-shaped patches of irritated skin-most commonly on the arms, back, buttocks, and lower legs-that may be crusted, scaling, and extremely itchy
• Neurodermatitis: scaly patches of skin on the head, lower legs, wrists, or forearms caused by a localized itch (such as an insect bite) that becomes intensely irritated when scratched
• Stasis dermatitis: a skin irritation on the lower legs, generally related to circulatory problems
• Dyshidrotic eczema: irritation of the skin on the palms of hands and soles of the feet characterized by clear, deep blisters that itch and burn

Atopic dermatitis is a chronic (long-lasting) disease that affects the skin. The word "dermatitis" means inflammation of the skin. "Atopic" refers to diseases that are hereditary, tend to run in families, and often occur together. These diseases include asthma, hay fever, and atopic dermatitis. In atopic dermatitis, the skin becomes extremely itchy and inflamed, causing redness, swelling, cracking, weeping, crusting, and scaling. Atopic dermatitis most often affects infants and young children, but it can continue into adulthood or first show up later in life. In most cases, there are periods of time when the disease is worse, called exacerbations or flares, which are followed by periods when the skin improves or clears up entirely, called remissions. Many children with atopic dermatitis enter into a permanent remission of the disease when they get older, although their skin often remains dry and easily irritated. Environmental factors can activate symptoms of atopic dermatitis at any time in the lives of individuals who have inherited the atopic disease trait.

The secret to resolving dry skin is not only having enough moisture, but also having that moisture located where it can actually resolve a dry skin condition. The use of artificial moisturizers (conventional lotions) only mask dry skin symptoms, which can result in more dry skin. Because most moisturizers do not seal in the body's own moisture, they artificially lubricate the outer layers of skin. When they wear off, the lubrication is gone and the original dryness remains. Sometimes this process will draw out the body's natural moisture and contribute to the dehydration process

The outer layer of skin is made up of dead skin cells, natural oils and lipids (fats). It is designed by nature to protect your deeper layers of skin from irritants and toxins. This is natural skin care at its very best. The outer layer of skin is made up of dead skin cells, natural oils and lipids (fats). It is designed by nature to protect your deeper layers of skin from irritants and toxins. This is natural skin care at its very best. Daily use of most soaps and cleansers can greatly reduce your skin's natural ability to repel the thousands of irritants and toxins that are commonly found in the home and work place. Once these irritants penetrate your outer layer of skin they can cause dry skin conditions, eczema, psoriasis, skin allergies and many other less desirable skin and health problems.

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