Mount Sinai’s Dr. Emma Guttman-Yassky says, “Eczema is now known to be an immune-driven disease.”
THE SPECIALIST: Dr. Emma Guttman-Yassky
The Director of the Center for Excellence in Eczema at Mount Sinai Medical Center, Dr. Emma Guttman-Yassky is a dermatologist who specializes in inflammatory skin diseases. The majority of her patients have eczema and other forms of dermatitis.
WHO’S AT RISK
The word might seem straight out of a crossword puzzle, but eczema is hugely common — a skin disease that affects 3% of American adults and 15% of children.
“Eczema is an inflammatory skin disease associated with patchy red lesions and extreme itching,” says Mount Sinai dermatologist Dr. Emma Guttman-Yassky. “In severe cases, the itching can be so bad that it keeps the whole family up at night. It’s a problem that has a major effect on the health system and patients’ lives.”
While the exact cause of eczema remains unknown, doctors have recently made some crucial discoveries. “For many years, we did not understand the primary trigger to eczema — whether it was an immune-related disease or driven by defects in the skin, what we call epidermal barrier,” says Guttman-Yassky. “Thanks to recent findings from clinical trials, eczema is now known to be an immune-driven disease that causes a defect in the epidermal barrier of the skin, which normally maintains the skin’s integrity.”
Equally common in men and women, eczema does have some identified risk factors. “Patients who have eczema have a much higher incidence of other allergic diseases, such as asthma, hay fever and food allergies,” says Guttman-Yassky. “About a third of eczema patients also have asthma, and some biologic treatments can potentially be used to target both of these diseases because they share some common pathways.” About 80% of eczema patients have a family history of it and other allergic diseases.
The vast majority of eczema cases arise in children who will go on to outgrow it. “Fifteen percent of all children have eczema, in comparison to only 3% of adults,” says Guttman-Yassky. “Seventy-five percent of the kids with eczema will outgrow it by age 10, but that still leaves millions of adult Americans living with eczema as a chronic disease.”
SIGNS AND SYMPTOMS
The hallmarks of eczema are scaly patches and itchiness, itchiness that in severe cases can become disabling.
“This disease causes a lot of problems because the patient can have an extensive rash all over the body, accompanied by such a strong itch that it can keep the whole family awake, increasing the risk of divorce in the parents of children with eczema and in adult patients themselves,” says Guttman-Yassky. “Eczema can also cause social problems when it affects the face and hands, and for some patients, the itching keeps them from focusing during the day on their work and school.”