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ECZEMA (Atopic Dermatitis; Infantile Eczema; Neurodermatitis)

DESCRIPTION

Eczema is a chronic allergic skin disorder of childhood. The skin--especially of the scalp, face, and back of the neck -- and skin creases of the elbows and knees are involved. Eczema may begin between 1 month and 1 year. It usually subsides somewhat by age 3, but it may flare again at ages 10 to 12 and last through puberty.
Appropriate health care includes:
  • Home care.
  • Physician's monitoring of general condition and medications.
  • Hospitalization (rare).

    SIGNS & SYMPTOMS
    Skin affected by eczema has the following characteristics:

  • Itching (sometimes severe).
  • Small blisters with oozing.
  • Thickening and scaling from chronic inflammation.

    CAUSES
    An allergic reaction to a wide variety of things, including:

  • Foods, such as eggs, wheat, milk, or seafood.
  • Wool clothing.
  • Skin lotions and ointments.

    RISK FACTORS

  • Stress.
  • Medical history of other allergic conditions in your child, such as hay fever, asthma, or sensitivity to certain drugs.
  • Clothing made of synthetic fabric, which traps perspiration.
  • Weather extremes, including humidity, severe cold, and severe heat (especially with increased sweating).

    PREVENTING COMPLICATIONS OR RECURRENCE

    No specific preventive measures.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory studies, such as blood and skin tests to identify your child's allergies.

    POSSIBLE COMPLICATIONS

  • Bacterial infections caused by injury to the child's skin.
  • Life-threatening infection from a smallpox vaccination--not usually given to children anymore since since smallpox has virtually been eradicated.
  • Cataracts (for unknown reason).

    PROBABLE OUTCOME

  • Variable. Some children outgrow eczema. Others are resistant to treatment, and eczema may persist through puberty. However, symptoms can usually be controlled with treatment.
  • Skin irritation from any other cause can trigger a flare-up or aggravate existing eczema.

    TREATMENT

    HOME CARE

  • Provide loose cotton clothing to help absorb your child's perspiration.
  • Minimize stress in the child's life whenever possible.
  • Don't allow the child to have a smallpox vaccination or to be exposed to someone who has recently had one.
  • Keep the child's fingernails short and put soft gloves on at night to minimize scratching. Scratching worsens eczema.
  • Bathe the child less frequently to avoid excessive skin dryness. Soap and water may trigger flare-ups. When bathing, use special non-fat soaps and tepid water. Use no soap on inflamed areas.
  • Lubricate the child's skin after bathing.
  • Protect the child from extreme temperature changes.
  • Avoid anything that has previously worsened the condition.

    MEDICATION
    Your doctor may prescribe:

  • Ointments containing coal tar or cortisone drugs to decrease inflammation. These may help your child more if used at night under a lightly applied plastic wrap. Ask your doctor.
  • Antihistamines to decrease itching.
  • Antibiotics for complicating infections, if they occur.
  • Sedatives or tranquilizers to calm the child.
  • See Medications section for information regarding medicines your doctor may prescribe.

    ACTIVITY
    No restrictions.

    DIET & FLUIDS
    No special diet. Eliminate any foods known to cause flare-ups of your child's eczema.

    OK TO GO TO SCHOOL?

    Yes. This condition is not contagious to others.

    CALL YOUR DOCTOR IF

  • Your child has symptoms of eczema.
  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects. Excessive use of cortisone drugs is dangerous, and antihistamines frequently cause drowsiness. ‡
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