That is the message of the Middle East’s only Eczema Support Group. Doctors and patients attended its first meeting in Dubai last week

Laith, 2, smiled and jangled his father’s car keys until his mother gently folded his ear and showed us his rash. It ran down the back of the ear in an angry red line.

Laith saw us looking at it, scrunched up his face and bawled. His father took him away while his mother stayed back to talk to us.

“The rash appeared about a year ago. We’ve taken him to four doctors and tried everything. His room is clean, he never wears fancy lotions or perfume, he takes a bath every day. But every time he stops using his medicine, the rash comes back. He’s upset, we’re upset, everyone’s upset,” Lama said.

Laith was the youngest person at the Eczema Support Group’s first meeting on Monday evening. Eczema is the most common inflammatory disease of the skin. It appears as redness, scaling and/or small blisters on the head, face, neck, or the insides of the elbows, wrists and knees.

Secondary lesions such as crusting, infection, or irritation from topical treatments often mask these features.

Also known as atopic dermatitis (AD), this non-contagious condition affects millions of children and adults worldwide.

“We lack exact data about the prevalence of eczema in the UAE. But we are clearly noticing an increase. Fifteen years ago doctors saw two patients with eczema a week. Now we see more than ten a week,” said Dr Mariam Mattar, family physician, Department of Health and Medical Services, and manager of the health centre at Dubai Ladies Club.

She chaired the support group meeting that was held in the club.

“This the first Eczema Support Group in the Middle East. It is open to patients and families of patients of all nationalities living in the UAE. We want to tell them you are not alone. We want to come together and show patients with eczema that there’s more to the condition than applying creams,” she added.

Carolyn Grace, headmistress of Rashid Paediatric Therapy Centre, Dubai, has been applying creams for 45 years, but the rash keeps coming back.

No known cure

There is no cure for eczema. Current therapy is directed at suppressing the inflammation and reducing triggering factors with topical treatments and ultraviolet light therapy.

“I’ve had eczema since I was a baby and now I’m nearly 50. You name it, I’ve used it. It has got better as I’ve grown older, but it still flares up now and then,” she said.

“As a child, I remember scratching all night and waking up with my eyelids bleeding. It was horrible.”

Everyone we spoke to at the meeting said the support group was a good idea. “It will particularly help expatriate mothers whose children have just been diagnosed with eczema,” Grace said.

The global pharmaceutical company Novartis is one of the group’s main partners. It has developed Elidel, a prescription-only non-steroid eczema cream that is being seen as a breakthrough. Elidel has been approved for use in the UAE in children aged two and above.

“We hope with our support more patients with eczema get to know each other and the group gets a life of its own. We hope to get them to network so that they don’t feel so alone,” said Elizabeth MacGillivray, head of marketing, pharmaceutical sector, Novartis Pharma Services Inc.

“A lot of expatriates do not have family here. Typically, family and old friends form a natural support group. But here expatriates with eczema will need to go out and find a support group,” she added.

Support at home and at school is crucial for children suffering with eczema, said Dr Ikramullah Al Nasir, specialist dermatologist and medical director of Dermacare Skin Centre, Dubai.

Dr Ian G. Jefferson, chief of paediatrics, American Hospital, Dubai, Dr Ayman A.J. Al Beiruti, specialist paediatrician of Welcare Hospital, Dubai, and Dr Al Nasir form the Medical Advisory Board of the Eczema Support Group.

“Children with eczema scratch all night, so they are tired and anxious in the morning. Sometimes parents behave as if the children are a burden on the family. Sometimes children are teased in school. That is totally wrong,” Dr Al Nasir said.

“I have always said treatment of children with eczema has to be done by a team.

Parents-doctors-teachers-caregivers must come together. Parents should never discuss the condition in front of the children. Maids should be trained.

Teachers should never let the children be teased. Everyone should know eczema is totally non-contagious and a child with eczema should be allowed to do everything,” he added.

More patients

Like Dr Mariam, Dr Al Nasir said he sees a greater number of eczema patients today. “Now I see up to 50 cases a month. We know eczema is caused both by genetic and environment factors. We can’t do anything about genetic factors, but we can keep away environment factors that trigger the condition,” he said.

“The UAE is hot, dusty and sandy. The water in the tap is hot the year around. There is too much air-conditioning. All this can bring an attack of eczema,” he pointed out.

“If you or your child has eczema, make sure the clothes are loose and of cotton; no one uses perfume; the house is spotlessly clean and neither too warm or cold. Someone with eczema is also prone to asthma and other allergies. Avoid all trigger factors.

“Also, don’t be stressed and do not think there is something to be ashamed about,” Dr Al Nasir underlined.

All information given to the Eczema Support Group will be kept confidential, Dr Mariam said at the meeting. The group will meet every six weeks at Dubai Ladies Club.

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Types of eczema
The word ‘eczema’ comes from Greek words that mean ‘to boil over’. Eczema is an itchy, non-contagious inflammation of the skin associated to a varying degree with other features such as:
• Redness of affected skin.
• Generally dry skin, which is often thickened in the areas that have been scratched.
• Lumps or blisters in affected areas.
• Signs of superficial infection such as weeping or crusty deposits.

Eczema is divided into a small number of subgroups based largely on what may be most important in causing eczema in an individual.

It is important to recognise that the symptoms and appearance of the skin in all these types can be exactly the same.

The main groups are:
Atopic: The ‘allergic’ type often seen in people who also have hay fever or asthma.

Allergic contact: Due to skin contact to a substance to which the individual is sensitive. The same substance does not cause eczema in a person who is not sensitive to it.

Irritant contact: Due to skin contact with irritating chemicals, powders, cleaning agents, etc. Contact with such a substance is likely to cause eczema in any person, although a degree of individual variation still exists.

Discoid: Appears as discrete islands of eczema on a background of normal skin.

Seborrhoeic: Appears in the nappy area and the scalp in infants. In adults, also appears on the scalp and in the skin creases between the nose and sides of the mouth. Can be caused by yeast infection.

Others: A miscellaneous group including ecze