ECZEMA, ATOPIC

Common, remitting and relapsing, skin condition causing itching and redness. Also called atopic dermatitis. Affects any part of the body, but typically the flexures. Occurs in all age groups but common in under-5s. Criteria for diagnosis of atopic eczema in a child Itchy skin plus three or more of the following symptoms:

• visible flexural dermatitis (involving skin creases)
• personal history of flexural dermatitis
• personal/immediate family history of asthma or allergic rhinitis
• personal history of dry skin in the past 12 months.
• onset of signs and symptoms under the age of 2 years.

Mainstay of treatment is liberal use of emollients (creams and lotions that provide a lipid film to reduce water loss) plus topical steroids of appropriate strength to manage exacerbations or as maintenance where necessary. Topical immunomodulators are used in moderate to severe cases as steroid-sparing agents. Other measures include dietary manipulation and irritant avoidance.