Chronic relapsing inflammatory skin condition with itch and impaired barrier function.
Risk factors
- • FHx atopy
- • Filaggrin mutation
- • Allergens, irritants
Clinical features
- • Itch, dry skin
- • Flexural distribution in older children/adults
- • Lichenification with chronicity
Management
- • Generous emollients (≥250 g/week adult)
- • Topical steroid potency by site/severity
- • Topical calcineurin inhibitor (tacrolimus, pimecrolimus) for face/flexures
- • Phototherapy, systemic immunosuppressants, dupilumab for severe
Complications
- • Bacterial infection (S. aureus)
- • Eczema herpeticum (urgent aciclovir)
- • Sleep disturbance, psychosocial
Clinical pearls
- • Stepped care; reactive vs proactive use
- • Eczema herpeticum: monomorphic punched-out vesicles, systemic upset
Educational — verify locally.
