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13.03.15 Eczema

Atopic march
  • Eczema 0-2 years
  • Hayfever 3-5 years
  • Then asthma


Baby eczema

  • Different distribution: Face, Trunk, Flexors
    • Extensors come later
  • Symptoms: Reduced feeding, FTT, Scratching +/- bleeding, Not sleeping, Infection (pustules, vesicles, weeping)


Management
  • Keep the water in and the allergens out with barrier moisturiser
  • Bathe every day (good for hydration + cleaning)
  • Steroids: Hit it hard, in bursts
    • Carry on until settled and for 3 more days
    • Don't ever go above eumovate for face/neck
    • Apply until you can see a shimmer (don't be shy)
    • Side effect: Thin skin with prolonged use
  • Protopics (tacrolimus)
    • Only if >2
    • ? Skin cancer risk
  • Treat infections


Steroid ladder

  • Hannah
    • 0.5% hydrocortisone is homeopathic
    • 1% is only any good for very, very mild eczema
  • Every
  • Boy's
  • Dream


Notes

  • Don't ever use calomine for anyything ever
  • Potassium permangenate
    • Antiseptic/astringent
    • Generally reserved for adults
    • Use it pink, never purple
  • Eczema flare look raised/rough and are more itchy
  • Untreated childhood eczema predisposes to severe, refractory adult eczema


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