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Assessing and managing atopic eczema in children

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Atopic eczema(atopic dermatitis) is a chronic, inflammatory, itchy skin condition that usually develops in early childhood. There has been a steep rise in atopic eczema, with as many as one fifth of children in developed countries now suffering from the condition.1

It is typically an episodic disease with flares (occurring two or three times per month) and remissions, but for some children it is continuous. Atopic eczema often has a genetic component that leads to the breakdown of the skin barrier. This makes the skin susceptible to triggers, including irritants and allergens, which can worsen the eczema.

In many children, atopic eczema clears or improves during childhood, but for others it will persist into adulthood. Some children with atopic eczema will go on to develop asthma and/or allergic rhinitis; this sequence of events is sometimes referred to as the atopic march.

Although atopic eczema is not always recognised as a serious medical condition by healthcare professionals, it can have a significant negative impact on quality of life.2

Diagnosis

Eczema is usually diagnosed on clinical grounds, taking into account the child's history, family history and appearance of the skin rash.3 Diagnostic criteria have been developed by NICE (see Box 1).4


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