Excema and Blepharitis

[Brighteyes]

Can anyone explain to me the exact connection between excema and blepharitis. It has just come to my attention that I have a small bout of excema on my right hand (its been there off and on for 4 years) and I have blepharitis (worse in right eye). I keep hearing/reading that having excema can predispose one to blepharitis but have been unable to get a precise explanation of the connection. Does having excema mean your skin is more likely to be the type that causes blepharitis or does having excema mean you have blepharitis until you get rid of the excema or get it under control or is it something else entirely? Thanks!

[Kathel]

Hi brighteyes,

I don't think there's an easy answer to your question, but I'll try my best. Belpharitis simply means inflammation of the eyelid margin. There is anterior blepharitis, which involves the outer skin surface, and posterior blepharitis, which involves the interior aspect. Anterior blepharitis can be caused by conditions such as eczematous dermatitis, allergic dermatitis, Demodex folliculitis, or seborrheic dermatitis. Posterior blepharitis, I think could be caused by rosacea, ocular irritants, etc. If you have hand dermatitis, it could be that you are predisposed to having dermatitis in other areas as well. I don't know that seborrheic dermatitis is more common with eczema patients (not in my experience), but they are both common conditions. Seborrheic dermatitis is very common in winter, with cold dry air. This environment seems to encourage the overgrowth of yeast, which triggers the problem. Anti-dandruff shampoos, which kill yeast in the scalp (where yeast is harbored) is very helpful in controlling seborrheic dermatitis (along with lid hygeine). As far as eczematous dermatitis, if it involves the eyelid, mild topical steroids or Elidel can be used judiciously.

In the case of your hand eczema, it may not be related to your eyes, but simply be a manifestation of environmental dryness. Get a good hand cream such as Neutrogena Norwegian Formula, Eucerin, Cetaphil, etc, and keep your hands hydrated. A little topical steroid can be useful for bad flareups.

Hope this helps. I practice dermatology, but am definitely an amateur ophthalmologist! (aren't we all!)

Good luck,

Kathel

[Lucy]

To Kathel-

Oh, we have a great group here! Looking at the above post, I thought I'd ask about psoraisis. I just learned I have this. I've had a patch on one elbow about the size of a nickel and more recently on the bottom of one of my feet. I happened to be visiting a dermatologist for something else and decided to show him my stuff. I have Sjogrens and, apparently, psoraisis is common for Sjoggies.

Reading your post about all the other skin stuff, I thought I'd ask about psoraisis. Thanks, Lucy

[Kathel]

Hi Lucy,

Psoriaisis is a very common problem; prevalence is about 1-2% of the population. Severity varies widely from one person to the next. Some, like you, only get a few patches, whereas others may have extensive involvement. Cases such as yours can usually be controlled with topical steroids. Tar preparations can also help, though they are messy. A little sun helps, though that would be hard if you're trying to treat your soles.

Psoriasisis is a disease of immune "dysregulation". Something is turning on the T-cells inappropriately. Commonn triggers are stress, alcohol, and bacterial infections. There is a genetic predispostion as well.

Hope that helps. The National Psoriasis Foundation is a good source of information. Not sure of their web address, but you could google it. Good luck,

Kathel

[Lucy]

Thanks, Kathel-
The psoraisis is the least of my problems and causes me no harm but an itchy foot not and again.

The suntan isn't for me because I had squamous cell skin cancer removed from my forehead in July. Since I have Sjogrens, I'll just count it as collateral damage and not worry about it. I do have some salve to help.
Lucy