Eczema

Question 1

Definition

Answer 1

Poorly demarcated itchy rash

• Most common type atopic eczema
• IgE mediated and T cell response

Question 2

Epidemiology

Answer 2

5% children in developed countries
Hx atopy in 70% of cases
Family Hx
Breast-feeding reduces risk

Question 3

Clinical Features

Answer 3

Rash on flexor surfaces around eyes and neck
-Children - scalp, face, flexor
-Adults - chest, neck, flexor
Pruiritis

Question 4

Complications

Answer 4

Lichenification - epidermal hypertrophy from scratching
Staph infection of lesion
Eczema herpeticum - widespread herpes infection
Cataracts - use of steroids around the eyes
Erythrodermic eczema >90% of body

Question 5

Management

Answer 5

GENERAL
Removal of identifiable cause

MEDICAL

1. Emollients - use regularly after steroids
   Mild - E45/Diprobase
   Moderate - Doublebase
   Severe - Hydromol ointment
2. Steroids (<5 days on face, <2wks on rest body)
   Mild - 1% hydrocortisone
   Moderate - 0.1% betometasone
   Severe -
   SE - skin thinning, striae formation, telangectasia, Cushing’s syndrome
3. Treatment staph infection
   - usually oral flucloxacillin
   - immune modulating agents - T cell suppressors