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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