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© 2022 IJRAR June 2022, Volume 9, Issue 2 www.ijrar.org (E-ISSN 2348-1269, P- ISSN 2349-5138)
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International Journal of Research and Analytical Reviews (IJRAR) www.ijrar.org
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CASE STUDY ON PATIENT WITH ATOPIC
DERMATITIS (ECZEMA)
Authors:
Name: Dr. Rakesh Gupta1 , Siddappa Naragatti2.
Designation: Consultant Physician (Yoga & Naturopathy)1 , Yoga Therapist2.
Affiliation: Central Council for Research in Yoga and Naturopathy, New Delhi, India1,2.
Abstract: Atopic dermatitis (AD) usually presents during childhood and rarely in the elderly. AD is
characterized by pruritus, erythematous papules, excoriations, lichenification and at times prurigo nodularis.
It is also associated with other atopic diseases and elevated serum immunoglobulin E (IgE). Atopic
dermatitis is difficult for patient to be treated because there is no specific treatment. Yoga, meditation along
with naturopathy and dietary regimen advised to the patient, to reduce the stress and anxiety. It helps a lot in
reducing the urge to scratch skin and improves confidence. It is very important to keep your mind relax and
fresh to keep away from mental stress. Yoga plays a vital role.
Key Words: Eczema, Yoga, Naturopathy, Diet
Introduction: Eczema, a form of dermatitis, is the most common inflammatory skin disorder. It causes
itching, redness, swelling and scaling of the skin. These symptoms are due to an allergic or inflammatory
reaction in the skin. The appearance, severity, symptoms and triggers vary among individuals1.
More than 31 million Americans suffer with some sort of eczema. The most common form of eczema is
atopic dermatitis. It accounts for most cases of eczema, affecting nearly 10 million children and over 16
million adults in the United States. Because atopic dermatitis often develops in the first six months of life,
people may call it baby eczema2.
Common sites for infant atopic dermatitis include scalp, ears, cheeks, elbows or knees. In older children and
adults, it often affects areas with creases. This includes the back of the neck, upper eyelids, elbows, wrists,
hands, back of the knees, and ankles3.
In most cases, atopic dermatitis comes and goes in flares. Usually, the flares lessen and the condition
resolves in adulthood. Sometimes, it remains a chronic condition4.
Atopic-or atopy-is a term that describes a genetic tendency to develop allergic diseases. People with atopic
conditions have an overactive immune response to allergens. So, atopic dermatitis is an allergic condition
that occurs when skin is more sensitive to certain substances than normal. It is not contagious5.
There is currently no cure for eczema, but eczema can be controlled with regular medical care and a good
treatment plan6. Some types of eczema can be prevented by avoiding stress, irritants, and things that cause
allergic reactions.
Eczema is generally not a serious condition, but there is a potential for complications, such as a secondary
bacterial or fungal infection of the eczema rash7. Seek prompt medical care if you have symptoms of
eczema. Early diagnosis and treatment can help reduce your risk of complications.
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Causes:
The exact cause of Atopic Dermatitis is still unknown, however, Atopic Dermatitis is usually associated
with the genetic variation which reduces the skin’s natural ability to protect itself from infections and
irritants. Some other factors are also found to be aggravating the conditions such as contact allergies,
digestive problems, nutritional deficiency, stress, food intolerance, and immune system problems7.
Symptoms of Atopic Dermatitis are:-
• Reddish patches or lesions
• Thick and rough skin
• Itching sensation especially during the night
• Dry and cracked skin around the affected area
• Chronic rashes8
Complications associated with Atopic Dermatitis:
• The most common complication is Asthma and Hay Fever
• Due to scratching and rubbing the skin is scarred
• Open wounds and cracks in the skin may lead to infections such as herpes simplex
• Constant itching sensation results in the fragile sleeping pattern9
• Increased anxiety and depression may lead to psychological problems
• According to a study, it may increase the risk of stroke and heart diseases
• It may aggravate, resulting in Neuro Dermatitis, Irritant-hand Dermatitis, and Allergic Contact Dermatitis
Types of eczema:
Atopic dermatitis is the most common type of eczema. The other types of eczema include:
Asteatotic eczema: This type of eczema causes fine cracks in the skin. It usually affects older
people in low humidity environments10.
Contact dermatitis: This form is the result of contact with irritants or allergens and is fairly
common. It often affects the hands only, so people may refer to it as hand eczema. Irritants include
detergents, solvents, or even plain water that gets trapped under jewelry or gloves. Allergens
include latex, metals and plants, such as poison ivy.
Dyshidrotic eczema: Pompholyx, palmoplantar eczema, vesicular eczema, and foot-and-hand
eczema are other names for this form. It causes tiny blisters on the hands and feet that are intensely
itchy. Common triggers include personal care products, metals, and hot weather.
Lichen simplex chronicus: Repeated scratching or rubbing of an area causes this form of eczema.
Neurodermatitis: This type of eczema usually occurs as one or two intensely itchy patches. The
most common sites are the arms, legs, and back of the neck. It is most likely an overreaction of
nerves to some sort of stimulus.
Nummular eczema: This form gets its name from the Latin word for coin. It occurs as round or
oval-shaped patches that itch and can ooze. It often develops after a skin injury or trauma, such as
bites, burns and abrasions.
Seborrheic dermatitis: The rash from this form tends to be greasy rather than dry because it
affects oily areas. This includes the scalp, hairline, and around the nose. It is commonly known
as cradle cap in infants and dandruff in adults.
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Stasis dermatitis11: Gravitational eczema, varicose eczema, and venous eczema are other names
for this form. It is the result of swelling and poor blood flow in the lower legs due to venous
insufficiency.
Case Presentation:
A 26 years old male patient residing in delhi came with the complained of Eczema. The patient
complained about redness and itchy skin on forehead, around eyes, face, neck and upper chest areas from
last six months.
The patient had been experiencing the problem since childhood with thickened, cracked, scaly skin on neck
& upper back; lower back; and on legs below knee joints.
Also, the patient had hypersensitivity reactions to allergens such as dairy products, processed foods, and
dust.
Usually, Atopic Dermatitis is seen first in very young children up to the age of five, and it may fade away as
the child matures. But in our present case, the patient is still suffering from the irritating rashes and itchy
skin. So, identifying triggers which cause the skin problems and addressing them can be the best treatment.
As the patient has the history of allergic reaction to certain food items, following correct diet and lifestyle is
most important. Also, reducing the itching sensation and red patches by the way of yogic practice, herbal
remedies and detoxification is recommended to the patient along with Naturopathy.
Intervention: Patient practiced yoga therapy12 session of one hour for 6 days per week for 45 days
including loosening exercises, Asanas, Pranayamas, Meditation and Kriyas and followed diet and natural
remedies which is advised during consultation.
Duration: 45 days
Frequency: One hour yogic practices for 6 days a week followed by proper dietary regimen.
Yoga Intervention:
Yogic sukshma vyayama: 10 min.
Yogic sthula vyayama: 5 min.
Suryanamaskara: 3rounds / 5 min.
Asanas: 15 min.
Uttanasana (Standing Forward Bend) – 2 rounds / 1 min.
Trikonasana (Triangle Pose)- 2 rounds / 1 min.
Janusirsasana (Head-to-Knee Pose)- 2 rounds / 1min.
Bhujangasana (Cobra Pose)- 3 rounds / 2min
Shashankasana (Hare pose)- 1 round / 1 min.
Vajrasana –(Thunder bolt pose}- 1 round / 2 min.
Pawanmuktasana (Wind relieving pose}- 2 rounds / 1min.
Mandukasana (Frog pose)- 3 rounds / 2 min.
Ardhmatsyendrasana (Half Lord of the Fishes Pose)- 2 rounds / 2 min.
Vakrasana (Twisted pose)- 1 round / 1 min.
Viparitakaraniasana (Legs up the Wall Pose)- 1 round / 1 min.
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Pranayama: (10 min.)
Anulom-vilom pranayama. – 9 rounds / 3min.
Bhramari pranayama. – 5 rounds / 2min.
Bhastrika pranayama – 3rounds / 2min.
Kapalbhati Kriya – 3rounds / 2min.
Ujjai pranayama. – 3rounds / 1min.
Special technique: Yognidra (10 min.)
Meditation: OM (Aum) chanting meditation (5 min.)
Kriyas: Jalneti (weekly once)
Naturopathy treatment13 at home: Proper bathing techniques, Mud Application ,Sunbath, Herbal wrap
(Ganji application).
Dietary regimen: Alkaline-Gluten Free Diet14, Herbal Nutritional Juice, Antioxidant Therapy, Poly-
unsaturated Fatty Acid Therapy, and Liver Detoxification Juice therapy. Avoid Junk food, oily food and too
much spicy food because they could create lots of health issue
Objective Data:
Symptoms
Before Intervention
After Intervention
Itching
++++
+
Blackish discoloration
+++
++
Scaling
++
+
Ulceration
++
+
Lab Investigation
Before Intervention
After Intervention
Hb (gm%)
12.2
13.4
TLC (per cumm)
8600
9700
Absolute eosinophil count
(per cumm)
570
360
Discussion: Within one and half month of yoga intervention along with proper diet and natural remedies as
advised for home, the redness and itchy skin on forehead, around eyes, face, Neck and upper chest areas got
healed. Also, the thickened and scaly skin slowly become normal during the course of treatment.
Review of literature:
The therapy of yoga has been explored in a growing number of randomized controlled trials to date15. A
recently published bibliometric analysis provided a comprehensive review of the characteristics of the
randomized yoga trials available in the literature16. The review included 366 full-text articles, with the 2
earliest studies published in 1975 and nearly 90% published within the last decade. In addition to healthy
patients, it was found these randomized controlled yoga trials most commonly enrolled patients with breast
cancer, depression, asthma, and type 2 diabetes mellitus.22 Another study examined psychological (eg, self-
rated stress and stress behavior, anger, exhaustion, quality of life) and physiological (eg, blood pressure,
heart rate, urinary catecholamines, salivary cortisol) measurements obtained before and after a 10-session
yoga program that participants completed over a 4-month period, with results showing significant
improvements (P .05) on almost all stress-related subjective and physiological variables. Results were
comparable with cognitive behavioral therapy17.
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Yoga helps patients on a psychological level, but a recent study reported that 90-minute sessions of
mindfulness meditation and gentle Hatha yoga over an eight week period led to observable benefits on a
cellular level, as telomere length was maintained in distressed breast cancer survivors compared to
decreases in telomere length in the control group with patients who solely participated in a stress
management seminar18. To date, there are no known studies examining the effects of yoga on patients with
skin cancer. However, a few studies have specifically examined the effect of yoga in managing non–cancer-
related dermatologic issues. Specifically, one small study of psoriasis patients found that those who listened
to mindfulness meditation tapes while undergoing standard phototherapy (psoralen plus UVA) healed faster
than those who underwent phototherapy treatment alone19. Because some dermatologic problems have
comorbidities and increased risk factors of other medical problems, such as psoriasis with psoriatic arthritis
and metabolic diseases (eg, abdominal obesity, diabetes, nonalcoholic fatty liver disease, dyslipidemia,
metabolic syndrome, chronic kidney disease), it is even more pertinent to recommend approaches for
healthy mind and body well-being as a supplement to medical care20.
Conclusion:
Atopic Dermatitis (Eczema) has been growing at an alarming pace across the world. It affects the young
children more but its onset can be easily seen in the adults too. And with lack of clarity on the actual cause
and apt treatment, preventing the disease onset and restricting it from aggravating further is the best way to
address the problem.
Natural Eczema treatment helps a lot in controlling the disease for a long time. Also, it imbibes certain
changes in lifestyle and diet to restrict the symptoms of the disease.
Alternative System therapies like Yoga, Naturopathy and Diet therapy can effectively address the root cause
of Atopic Dermatitis such as immune system dysfunction. With a well-planned nutritional diet and
treatment based daily regimen, a person can alleviate the disease condition and lead a healthy life.
References:
1. Nemeth V, Evans J. Eczema. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure
Island (FL): StatPearls Publishing; 2022 Jan-. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK538209/
2. Nutten S: Atopic Dermatitis: Global Epidemiology and Risk Factors. Ann Nutr Metab
2015;66(suppl 1):8-16. doi: 10.1159/000370220
3. Siegfried, E. C., & Hebert, A. A. (2015). Diagnosis of Atopic Dermatitis: Mimics, Overlaps,
and Complications. Journal of clinical medicine, 4(5), 884–917.
https://doi.org/10.3390/jcm4050884
4. Lee, J. H., Son, S. W., & Cho, S. H. (2016). A Comprehensive Review of the Treatment of
Atopic Eczema. Allergy, asthma & immunology research, 8(3), 181–190.
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5. Boguniewicz, M., & Leung, D. Y. (2011). Atopic dermatitis: a disease of altered skin barrier
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Silverberg, J. I. (2018). Sleep Disturbance and Sleep-Related Impairment in Adults With
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Atopic Dermatitis: A Cross-sectional Study. Dermatitis : contact, atopic, occupational,
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