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Childhood atopic eczema management and diagnosis

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Dry skin, poorly dermarcated erythema, lichenifica Dry skin, poorly dermarcated erythema, lichenification and some evidence of excoriation

Most cases of atopic eczema (AE) are managed in the primary care setting and eczema in children may be sub-optimally managed, despite appropriate therapeutic options being initiated. There may be a reluctance to gain symptomatic control in children by using topical corticosteroids and emollients are often under-prescribed. Moreover, the reluctance to use topical corticosteroids is also seen with patients.1

Epidemiology

AE may develop in infancy and have a remitting and relapsing course. It is a chronic, itchy, inflammatory skin condition that commonly presents in general practice1, 15-20% of school-aged children may be affected by AE in the UK.2 Genetic and environmental factors are likely to be contributory.3 It is thought that abnormalities in structural proteins such as filaggrin or abnormal lipid metabolism may compromise epithelial barrier function and cause the skin to become more sensitive to irritants and allergens.4

Whilst the severity of AE and its impact on quality of life are not necessarily linked there may be a significant psychosocial impact.1 Furthermore AE may cause poor sleep, growth concerns and have an impact on a child’s family. Poor sleep may result in poor concentration at school as well as behavioural difficulties.4

Diagnosis


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