Eczema

Question 1

What words might you use to describe an eczematous rash?

Answer 1

• Chronic, relapsing
• Dry
• Pruritic
• Erythematous
• Papules/vesicles
• Secondary erosions/lichenification
• Secondary infection (crusted, weeping)

Question 2

When is most commonly the onset of eczema? What proportion of children have some form of it?

Answer 2

• First year of life
• 80% (most grow out)

Question 3

Describe the ongoing care you might recommend for a child with asthma (not an acute flare)

Answer 3

• Skin care - emollients, cool salt/oil bath
• Environmental change - avoid heat, dryness, prickles, allergens

Question 4

Describe the care you might recommend for a child with an acute flare of eczema

Answer 4

• Methylpred ointment 3-5 nights
• Hydrocortisone bd PRN following
• Cool compresses QID
• QV cream QID
• Cool bleach/oil/salt bath daily
• Wet dressings nocte
• Wet clothing QID
• Ongoing care (emollients, cool baths, avoid environmental triggers)

Question 5

Describe the different management for a child with eczema that is:

• Infected
• Not initally responsive to steroids
• Lichenified

Answer 5

• Infected - cephalexin for 1 week
• Not initally responsive to steroids - wet dressings/glad wrap
• Lichenified - tar (not to face/groin)

Question 6

How might you manage eczema herpeticum?

Answer 6

• Remove crusts (soaking or compresses)
• Oral acyclovir +/- cephalexin for suprainfections