EczemaPaeds in afya

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15-20% of children, increasingly common 
typically presents <6/12 but clears in 50% of 5y and in 75% of 10yr

''Features''
    infants - face and trunk
    younger children - extensor surfaces
    older children - flexor surfaces and creases of face and neck

''Management''
    avoid irritants
    simple emollients: large quantities (e.g. 250g / week) - apply 30mins prior to steroid - Creams soak into skin faster than ointments 
    topical steroids (10:1 emollient :steroid)
    in severe cases wet wraps and oral ciclosporin may be used

Note - Emollients can become contaminated with bacteria - fingers should not be inserted into pots (use pump dispenser)
50% kids find E45 irritative
18% kids find other emollients irritative

''Eczema herpeticum''
severe primary infection (systemic upset) of skin
herpes simplex virus 1 or 2. 
seen in children with atopic eczema. 
potentially life threatening so admit for IV aciclovir

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