Care and Mobility Considerations

Eczema is usually a mild intermittent condition with minimal function effects for the majority of the time.

During flare-up of eczema the patient experiences discomfort and irritation that may interfere with sleep. Eczema of the hands, particularly when there is significant fissuring or cracking of the skin, may cause temporary impairment of manual dexterity with difficulty doing up buttons or using implements. Eczema affecting the feet may make standing and walking uncomfortable for a short period until the rash subsides.

Creams or ointments may need to be applied to areas that the patient is unable to reach and help may be needed with this. However in most cases the attack would be expected to last no more than 3-4 weeks at this level of severity and in the recovery phase, although there may be residual skin rash, there should be no loss of ability to deal with personal functions or the ability to walk.

In rare cases of resistant eczema, particularly those where there is long standing damage to the skin from friction or scratching, healing does not occur and longer term difficulty with manual dexterity may be evident. These patients are usually under specialist care and evidence of persistent functional disability needs to be sought and each case considered in on its own merits.

Variability

Eczema usually follows a pattern of exacerbation (flare-up) and remission (recovery) with periods between attacks when the skin is apparently normal. Attacks can last for several weeks at a time often with several months between. Repeated contact with irritants or sensitizers may induce exacerbations and the patient would be expected to be able to take action to avoid contact with known precipitating factors.

In some cases, particularly in atopic eczema, there may be a chronic low grade rash although this rarely would be expected to cause functional disability.