ezcema Flashcards
How do you classify eczema and what are the features of each?
Clear - dry but no active disease
Mild - dry but not that itchy
Moderate - dry and itchy a lot
Severe - dry and really really itchy, skin thickening, cracking, oozing etc
Infected - fever, pus, crusted, weeping
Mild eczema mx
Emollients
Mild corticosteroid - hydrocortisone 1 percent
Moderate eczema mx
Emollients
Moderate corticosteroid e.g. betnovate RD
Topical calcineurin inhibitors
Antihistamine
Severe eczema management
Emollients
Potent steroids
Topical calcineurin inhibitors
Name a potent steroid
Betamethasone valerate 0.1 percent = BETNOVATE
Name a moderately potent steroid
Betamethasone valerante 0.025 percent = BETNOVATE RD (really diluted)
EUMOVATE = clobetasone butyrate 0.05 percent
Conservative management of eczema
Loose clothing, organic clothing, avoid triggers like overheating, grass, detergent etc
VIT D
Avoid scratching - short nails, rub area, use anti-scratch mittens
Moderate or severe ezcema with severe itch - what would you prescribe?
1 m of non sedating antihistamine
If the itch was affecting sleep in severe eczema, what would you prescribe?
2 weeks of sedating antihistamine
e.g. chlorphenamine
Where would you avoid giving potent steroids?
Face and axillae and genitals
When would you refer?
If there is no response, diagnosis uncertain, recurrent secondary infection
Infected eczema - mx
What organisms can infect? what is this called
Fluclox
If allergic - clari
If preg and allergic - erythro
+ topical fucidic acid
Organisms:
Staph aureus
HSV - eczema herpeticum
Fungal infections
What advice would you give about prognosis of eczema
Higher risk of asthma, allergic rhinitis, food allergy
Local SE of corticosteroids
Stinging, thinning of skin, permanent striae, contact dermatitis, depigmentation
Systemic SE of corticosteroids
Adrenal suppression, Cushing’s, growth suppression
