{"id":446,"date":"2017-03-26T14:18:38","date_gmt":"2017-03-26T14:18:38","guid":{"rendered":"http:\/\/papergp.com\/index.php\/dermatology\/eczema\/"},"modified":"2023-01-24T11:25:26","modified_gmt":"2023-01-24T11:25:26","slug":"eczema","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/dermatology\/eczema\/","title":{"rendered":"Eczema"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4><strong>Data gathering<\/strong><\/h4>\n<ul>\n<li>Red flags\n<ul>\n<li>Blistering of the skin<\/li>\n<li>Painful areas of skin<\/li>\n<li>Fever<\/li>\n<\/ul>\n<\/li>\n<li>Others\n<ul>\n<li>Growth and development<\/li>\n<li>Joint problems, job<\/li>\n<li>Triggers (washing powders, soap, stress)<\/li>\n<li>CMPA &#8211; GI symptoms, Wheeze<\/li>\n<\/ul>\n<\/li>\n<li>Examine\n<ul>\n<li>Distribution<\/li>\n<li>Crusting<\/li>\n<li>Weeping<\/li>\n<li>Excoriation<\/li>\n<li>Scarring<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4><strong>Clinical management<\/strong><\/h4>\n<ul>\n<li>Explanation\n<ul>\n<li>Irritation of the skin leading to dry itchy skin with flare ups &#8211; the cause is not fully known but known to run in families and may be linked to immune system &#8211; can sometimes become weepy and infected<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Treatment\n<ul>\n<li>Lifestyle\n<ul>\n<li>Avoid triggers &#8211; perfumes, soaps, synthetic materials<\/li>\n<li>Avoid scratching, wear cotton, non biological detergents<\/li>\n<\/ul>\n<\/li>\n<li>Medications\n<ul>\n<li>Emollients<\/li>\n<li>Topical steroids for flare ups<\/li>\n<\/ul>\n<\/li>\n<li>Infection\n<ul>\n<li>Presentation: crusting, weeping, pustules, cellulitis<\/li>\n<li>Small area: topical fucidic acid<\/li>\n<li>Larger area: oral flucloxacillin or clarithromycin<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Follow-up \/ Safety net\n<ul>\n<li>Refer\n<ul>\n<li>Poor response to treatment<\/li>\n<li>Recurrent infections<\/li>\n<li>Suspected dietary factors (consider CMPA for moderate eczema with onset &lt; 6months of age)<\/li>\n<\/ul>\n<\/li>\n<li>Admit\n<ul>\n<li>Eczema herpeticum<\/li>\n<li>Erythroderma<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<p><strong>Emollients<\/strong><\/p>\n<ul>\n<li>use 3-8 times per day<\/li>\n<li>ointments are more effective than creams (but less well tolerated)<\/li>\n<li>remove emollients with clean spoon to avoid contamination<\/li>\n<li>avoid emollients with preservatives e.g. E45<\/li>\n<li>avoid aqueous cream due to skin reactions<\/li>\n<li>bath additives are not recommended as increased risk of falls and no evidence of efficacy<\/li>\n<\/ul>\n<p><strong>Topical steroids<\/strong><\/p>\n<ul>\n<li>Use early in flares (redness, inflammation, itching)<\/li>\n<li>Step up potency if required after 7 days<\/li>\n<li>Care in flexures as potency of cream increased<\/li>\n<li>30 minute gap between application of steroid and emollient<\/li>\n<li>Ointments preferable to creams (avoids preservatives) unless skin weeping<\/li>\n<li>Allow a four week gap between courses of potent steroid treatments<\/li>\n<\/ul>\n<p><strong>Topical steroid potencies<\/strong><\/p>\n<ul>\n<li>Topical steroids\n<ul>\n<li>Hydrocortisone 0.5% &#8211; Mild<\/li>\n<li>Hydrocortisone 1% &#8211; Mild<\/li>\n<li>Eumovate (Clobetasone butyrate 0.05%) &#8211; Moderate<\/li>\n<li>Elocon (Mometasone furoate 0.1%) &#8211; Potent<\/li>\n<li>Dermovate (Clobetasol propionate 0.05%) &#8211; Very Potent<\/li>\n<\/ul>\n<\/li>\n<li>Topical steroids with antimicrobials\n<ul>\n<li>Daktacort &#8211; mild steroid + antifungal<\/li>\n<li>Fucidin H &#8211; mild steroid + antibacterial<\/li>\n<li>Trimovate &#8211; moderate steroid + antibacterial + antifungal<\/li>\n<li>Fucibet &#8211; potent steroid + antibacterial<\/li>\n<li>Lotriderm &#8211; potent steroid + antifungal<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Data gathering Red flags Blistering of the skin Painful areas of skin Fever Others Growth and development Joint problems, job Triggers (washing powders, soap, stress) CMPA &#8211; GI symptoms, Wheeze Examine Distribution Crusting Weeping Excoriation Scarring &nbsp; Clinical management Explanation Irritation of the skin leading to dry itchy skin with flare ups &#8211; the cause &hellip; <a href=\"https:\/\/papergp.com\/index.php\/dermatology\/eczema\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Eczema<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":442,"menu_order":173,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-446","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/446","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=446"}],"version-history":[{"count":9,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/446\/revisions"}],"predecessor-version":[{"id":1425,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/446\/revisions\/1425"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/442"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=446"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}