Eczema (Atopic Dermatitis)

• Chronic (with or without acute exacerbation) inflammatory skin disease
• Often starts in childhood which may persist into adulthood

• Acute presentation: erythematous pruritic vesicular eruptions with or without serous exudate
• Subacute presentation erythematous skin lesion with scaling and/or crusting
• Chronic: lichenification may be present + hyperpigmentation +/- excoriation marks/scars

• The aim of management is to break the "itch and scratch" cycle
• Mild cases can be treated with wet dressing + topical emollient
• If chronic → medium strength to potent topical steroids e.g. 0.1% triamcinolone or 0.1% betamethasone
• If topical steroid unsuccessful, a low-dose oral steroid may be beneficial
• Other treatments
  • Oral antihistamine e.g. loratadine 10 mg OD for itchiness
  • Antibiotics if infected skin or impetiginisation/cellulitis
  • Rule out contact dermatitis and fungal infections