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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.

NICE CG57 Atopic eczema in under 12s: diagnosis and management; 2007 (updated 2021) https://www.nice.org.uk/guidance/CG57
NICE Pathways. Eczema; 2021 https://pathways.nice.org.uk/pathways/eczema
NICE NG190 Secondary bacterial infection of eczema and other common skin conditions: antimocrobial prescribing; 2021 https://www.nice.org.uk/guidance/ng190 
National Eczema Society https://www.eczema.org

Practice Nurse featured articles 

Eczematous conditions in older skin Sandra Lawton 

A case of atopic eczema: a guideline-based approach Mary Lowth  

Effective management of atopic eczema Mandy Galloway 

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