Childhood eczema

摘要

Confirm the diagnosis by thorough examination and exclude secondary infection.Drug treatment-Prescribe an emollient in sufficient quantities. (Infants require 250 g per week, to be applied twice daily.) Advise that several different products may be tried before the most suitable is found. In general, greasy ointments are preferable for dry skin or at night, and creams are preferable for inflamed areas and during the day. Prescribe a bath additive or soap substitute, or both. Because the skin is very inflamed, prescribe a mild topical steroid (such as hydrocorti-sone 1% ointment). Emphasise that this is for short term, intermittent use and should be avoided near the eyes. Once daily administration, rather than twice daily, is recommended as a first step. There is no evidence for prescribing combinations of topical steroids and antimicrobials over steroids alone. Exudate or crusting suggests secondary bacterial infection, and topical antibiotics should be started, with consideration of local resistance. Systemic antibiotics may be needed in more severe cases or if topical treatment is ineffective.