Dermatological

Question 1

What are the features of eczema in children?

Answer 1

itchy, erythematous rash
repeated scratching may exacerbate affected areas
in infants the face and trunk are often affected
in younger children, eczema often occurs on the extensor surfaces
in older children, a more typical distribution is seen, with flexor surfaces affected and the creases of the face and neck

Question 2

How should eczema be managed?

Answer 2

Coded in the notes
Referral to Paediatrician with interest in dermatology/allergy
Advice for parents:

1) avoid irritants
2) simple emollients
large quantities should be prescribed (e.g. 250g / week), roughly in a ratio of with topical steroids of 10:1
if a topical steroid is also being used the emollient should be applied first followed by waiting at least 30 minutes before applying the topical steroid
creams soak into the skin faster than ointments
emollients can become contaminated with bacteria - fingers should not be inserted into pots (many brands have pump dispensers)
3) topical steroids
4) wet wrapping
large amounts of emollient (and sometimes topical steroids) applied under wet bandages
in severe cases, oral ciclosporin may be used

Question 3

Which is itchier: eczema or discoid eczema?

Answer 3

Discoid eczema