Details
Story
- 14 month old Caitlin has had very troublesome eczema for the last 3 weeks. She is not sleeping – nor are her parents. It is very difficult to apply the ointments and creams because she is so distressed and itchy. Her skin is oozing and her clothes are sticking.
- The parents want Caitlin referred for allergy tests to work out why her eczema is so bad.
Medical review
- The GP noted that her skin was very red, inflamed and oozing, with some crusting in keeping with impetigo (infection).
- After taking some skin swabs, Caitlin was prescribed a two week course of flucloxacillin.
- 48 hours later, Caitlin was less distressed and the parents were able to apply the moisturiser and the 1% hydrocortisone ointment regularly again.
Learning point
- Eczema can usually be managed with regular moisturiser and if needed 1% hydrocortisone ointment up to twice a day to inflamed skin. Sometimes 1% hydrocortisone needs to be given regularly for a number of weeks or even months to keep the eczema controlled.
- Crusty, oozing skin that sticks to the clothes is usually infection. That is why the ointments don’t work. The child should be seen by the GP and is likely to benefit from a course of antibiotics.
- Allergy (blood and skin prick) tests maybe helpful for investigating immediate allergic reactions, but not for eczema. In some young children with severe eczema food is the culprit, but for correct diagnosis, the patient may need a 4 week trial off the possible food trigger. This needs to be done with the help of your doctor and/or dietitian.
Case Studies Details
- 28 Apr 2017
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