Eczema Flashcards
Eczema
Chronic atopic condition caused by defects in the normal continuity of the skin barrier, leading to inflammation in the skin
Presentation of eczema in infancy
Dry
Erythematous
Itchy
Sore patches
Over flexor surfaces
(in neonates can be extensor surfaces)
Occurs in flares
Pathophysiology of eczema
Gaps in the skin barrier provides an entrance for irritants, microbes and allergens that create an immune response
Results in inflammation
History for eczema
SOCRATES Itch History of atopy Smoking Washing powder FHx What they have used before
Management of eczema
Maintenance:
- emollients
Flares:
- emollients
- topical steroids
- wet wraps
- antihistamine - pruritis
- treat superimposed bacterial or viral infection
Role of emollients
Trap water within skin, preventing evaporation
Create barrier for skin
Types of emollients
Lotion - least greasy
When should emollients be applies
Often and sparingly
Commonly after shower and before bed
What to avoid in eczema
Avoid activities that break down the skin barrier:
- bathing in hot water
- scratching or scrubbing skin
- using soaps and body washes that remove the natural oils in the skin
- avoid triggers such as smoking, pollution, chemicals
Soap substitutes
Emollients that can be used as soap
Environmental triggers of eczema
Changes in temperature
Certain dietary products
Washing powders
or cleaning products
Emotional events or stresses
Wet wraps
Covering affected areas in a thick emollient and applying a wrap to keep moisture locked in overnight
Specialist treatments in severe eczema
Zinc impregnated bandages
Topical tacrolimus
Phototherapy
Systemic immunosuppressants:
- oral corticosteroids
- methotrexate
- azathioprine
Rule for topical steroids
Weakest steroid for the shortest period required to get the skin under control
Purpose of topical steroids
Reduce inflammation
