What is eczema?
- Eczema is the commnonest itchy rash in childhood.
- Onset:
- It starts at about 2-3 months of age usually.
- Characteristics:
- It may range from local erythematous scaly rash, to
extensive wheeping bleeding lesion.
- It is very itchy, and it can make the child so irritable that the sleep, emotion and behaviour may be disturbed.
- If there is superinfection, it may cause exacerbations in otherwise quiescent lesions.
- Distribution:
- Characteristically involves different parts of the
body at different ages.
- At 2-3 months, it usually involves the face, sternal area, nappy area, extensor surfaces of elbow and knees.
- For toddlers, it involves the neck, flexural surface of elbow, knee and ankle joints.
- For older childre, it usually involves the palm, foot, flexural surfaces of limbs.
What are the causes of eczema?
- Eczema has genetic predisposition, as well as environmental factors(allergens). The child usually has other allergic disease, like asthma, allergic rhinitis or urticaria.
- Environmental factors include food and contact allergent, common ones are:-
- milk or egg protein,...
- woolen clothing, detergent or
additives,...
- food like peanuts, food additives,...
- animal like cats, dogs, rabbit....
How to manage a child with eczema?
- Usually, one has to see a doctor to make sure it is eczema, because there are many other conditions looked very similar:
- Seborrhoeic dermatitis
- Contact dermatitis
- Fungal dermatitis
- Psoriasis
- Insect bites
- Scabies
- The most important thing is to avoid the allergent, if known. Of course, it is easier said than done.
- Doctor's treatment is usually supportive:-
- cold tar, emulsifying ointment
- weakest strength of steroid application
- antihistamine, (scretching make it worst)
- topical or oral antibiotics for bacterial
exacerbations
- Prognosis is good:-
- 70% recovered at 2-5 yars of age
- 15% mild eczema persist to adulthood
- 15% more difficult course
|
