Atopic Eczema

Question 1

What is it?

Answer 1

Dryness and itching of the skin that occurs on the flexor surfaces

Question 2

What causes it? (2)

Answer 2

Abnormal Th2 pathway causing inflammation in the skin and abnormal Filaggrin proteins controlling the epidermal barrier

Question 3

What are the triggers? (10)

Answer 3

Infection, Atopy, Strong detergents, chemicals, teething, anixety, stress, cat and dog fur, dust mites, food allergies

Question 4

What features does the skin show?

Answer 4

A vesicular or bullae rash in the acute phase due to itching which then becomes lichenified in the chronic stages

Question 5

Is it common?

Answer 5

Very, it affects 5% of the UK population

Question 6

Who does it affect?

Answer 6

It is very common in early life affecting 10-20% of children, but often grow out of it

Question 7

Signs and Symptoms (8)

Answer 7

Itching, erythematous, scaly patches on the flexor surfaces, weeping, vesicles, skin thickening/lichenification (due to excessive scratching), papular or follicular

Question 8

Investigations (2)

Answer 8

Clinical diagnosis, Can test for high serum IgE levels (Atopy)

Question 9

What is the treatment? (10)

Answer 9

Avoid triggers, education, strict emollient routine, soap substitutes, topical steroids, antihistamines, oral antibiotics and oral steroids, bandaging, phototherapy

Question 10

Complications (3)

Answer 10

Infection of broken skin with S.Aureus, viral infection (Eczema Herpeticum by HSV), retarded growth in severe cases

Question 11

Is there a good prognosis?

Answer 11

80% of cases will spontaneously resolve as the child ages