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Simple treatments help boy's severe eczema

TAMPA

By the time Ethan Russell was 5 months old, it was clear he had inherited more from his mother than her hazel eyes and brown hair. Ethan had large red patches on his otherwise creamy skin. They were the telltale signs of eczema, a problem Norrine Russell, 41, had suffered with for years.

Now it seemed Ethan had it, too, only it was much worse than Norrine's ever was. At first, the swollen, red blotches were on his elbows, the backs of his knees and his torso. Within a year, despite seeing a number of pediatric specialists, eczema covered most of Ethan's tiny body. "His face looked horrendous," his mother said. "He had eczema everywhere, his arms, legs, torso. The only places not affected were his forehead and his tush."

After a nearly two-year, cross-country search for answers, the mother of two discovered that certain everyday foods were making Ethan's eczema worse. She also found that a simple, at-home treatment would help lessen the symptoms by killing a common but difficult-to-treat skin infection that can accompany severe eczema.

About 10 percent of all American infants and children will have eczema at some point, according to the National Eczema Association, although most cases are far milder than Ethan's.

Scientists think a faulty immune system is at least partly to blame for eczema. So are genetics. The skin disorder tends to run in families, especially when there's also a history of allergies, hay fever or asthma, as there is in the family of Ethan's father, Pete Russell.

Eczema, or atopic dermatitis, is an inflammation of the skin that leads to very itchy red or brownish patches that look like a rash. The patches can become crusty, bumpy, oozing, cracked and/or thickened. The first outbreak usually appears before age 5, but the condition can persist into adulthood. In severe cases, like Ethan's, a staph infection can accompany the rash.

• • •

Pediatricians counseled patience, but Norrine Russell knew her son — whose eczema was so bad he left blood stains on his sheets — was miserable. As was the entire family.

"I wanted it gone," she says, "I didn't want him to have any eczema. I wanted something to make it go away." He was tested for food allergies and taken off eggs and wheat. When things didn't improve, he was allowed only a hypoallergenic amino acid infant formula — tough for a child who already had strong food preferences. Family meals became impossible.

Worse yet, several antibiotics failed to stop the staph infection.

Russell applied her skills as a research psychologist to the task and scoured the Internet for information. Last December, she stumbled on a promising lead: Researchers at Northwestern University in Evanston, Ill., had given patients with staph infections baths in water containing a small amount of household bleach — just a half cup in a 40-gallon bathtub. The results during clinical trials were so successful, the study was stopped and all patients got the treatment.

Russell contacted the lead researcher, found out exactly what to do and started the protocol. "That night I could see the infection responding," she says. "It's less (bleach) than what you would put in a swimming pool, but just enough that it started to kill the staph on his skin. The baths were a lifesaver."

Adding to her sense of urgency: Russell learned she was pregnant, and feared exposing her newborn to the bacteria.

• • •

Dr. Neil Fenske, a Tampa dermatologist and chairman of the department of dermatology at USF Health, says the diluted bleach bath approach is often recommended for eczema patients with staph infections. "It's very cost-effective and it works," says Fenske. In fact, he tells parents to use as little as a tablespoon of bleach in a tubful of water. "That little amount of bleach is antiseptic and is a very effective way to kill all the bacteria without having to give the patient antibiotics."

Fenske wasn't surprised Russell didn't hear about it from the first round of doctors she consulted.

"Very few doctors offer basic medical dermatology today. It's all cosmetic dermatology. Plus, eczema is very complex. It's a disease you can do a lot for but it takes a lot of effort and few doctors can take the time. It's one of the realities of medicine today."

• • •

A month after the bleach discovery, there was another breakthrough when Russell landed on a website about childhood food allergies and saw rave reviews for a program at a hospital in Denver, National Jewish Health.

Within four days of arriving there, Ethan's skin had improved so much that strangers stopped staring.

Eczema patients often are advised to keep bath time short and skin dry. But in the "soak and seal" method used at National Jewish, patients take 20-minute baths three times a day, followed by liberal use of topical medication. Patients put on wet pajamas, then dry pajamas over those to lock in moisture. Ethan's body healed quickly, but his head had to be wrapped in bandages, mummy-like, for the entire two-week treatment program.

• • •

With the eczema under control, the medical team began focusing on Ethan's food allergies and came up with nine foods he could safely eat.

A limited diet, but cause for rejoicing. "To come home with nine foods that are safe, including milk and soy, is huge,'' Russell said. She has slowly started introducing additional foods.

She knows well that eczema is a chronic condition, but hopes that he will be less prone to flareups as he gets older. Meanwhile, she has learned to keep it well in check.

On Ethan's second birthday last week, the family enjoyed a dinner of turkey, mashed potatoes, broccoli and vanilla ice cream. Norrine, husband Pete and Ethan hadn't had a family meal together in a year.

"Just sitting at the table with him makes it all worthwhile," she says.

Irene Maher can be reached at imaher@sptimes.com.

More on eczema

For more information, go to the National Eczema Association's website: nationaleczema.org. To learn about bleach baths to treat bacterial infections, go to www.mayoclinic.com (search for "bleach bath'').

For more about National Jewish Health's program for pediatric eczema, go to www.nationaljewish.org or call toll-free 1-800-222-5864.

More on allergies

The good news about food allergies is they're not as common as some believe. The true incidence is only about 8 percent for children and less than 5 percent for adults, according to a federally commissioned report issued this year. But the condition is sometimes confused with food sensitivities, which are less serious. An expert panel is working on guidelines to more clearly define food allergies and help patients manage better; a final draft is expected later this summer.

In the meantime, Norrine Russell suggests this

website for families dealing with food allergies in children: www.kidswithfood

allergies.org.

Simple treatments help boy's severe eczema 06/16/10 [Last modified: Thursday, June 17, 2010 8:10am]

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