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Managing a case of childhood atopic eczema effectively

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Most cases of atopic eczema (AE) are managed in the primary care setting, yet 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. Parents may also be reluctant to use topical corticosteroids on their children.1

AE can develop in infancy and have a remitting and relapsing course. It is a chronic, itchy, inflammatory skin condition,1 and it is estimated that 15 to 20 per cent of school-age children in the UK are affected by AE.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

While the severity of AE and its impact on quality of life are not necessarily linked, there may be a significant psychosocial impact.1 AE can 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


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