eczema

Question 1

eczema in kids - when present? will it last forever?

Answer 1

presents before 6mo

clears in 50% by 5y and 75% by 10y

Question 2

eczema - where does it occur in children

Answer 2

infants - face + trunk
young kids - extensor surface
older kids - flexor surfaces + face + neck creases

Question 3

eczema in kids - management

Answer 3

avoid irritants
simple emollients
topical steroids
wet wraps + oral ciclosporin

Question 4

eczema in kids - how to use simple emollients

Answer 4

all over, several times a day
apply emollient then 30min later steroid
don’t put fingers in pot
250g/week, 10:1 w topical steroids

Question 5

rash with scale or desquamation - where is pathology?

Answer 5

epidermis - keratinocytes make scale

Question 6

what can be used for facial eczema in a kid? how long for?

Answer 6

1% hydrocortisone ointment - mildest topical steroid for application to the face
3-5d max

Question 7

atopic eczema - symptoms + distribution

Answer 7

xerosis - generalised dry skin
erythematous lesions
excoriation
lichenifications
\+- infection eg vesicles
itching

babies - face
flexor surfaces
wrists + ankles

Question 8

atopic eczema - investigations

Answer 8

ask re asthma, hayfever, allergies
if infection - swab skin

no investigations needed but:
serum IgE - raised
skin prick or RAST

Question 9

atopic eczema - management

Answer 9

education + trigger avoidance
emollients +- wet wraps
topical steroids - lowest potency first
abx - if infected

Question 10

eczema herpeticum - management

Answer 10

derm emergency

aciclovir

Question 11

atopic eczema - complications

Answer 11

chronic dry skin
poor sleep
psychological if severe
conjunctivitis + blepharitis

infection:
staph aureus - pustules, yellow crusty sores
herpes simplex - eczema herpeticum - emergency