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Childhood atopic eczema

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VOL: 101, ISSUE: 37, PAGE NO: 33

WHAT IS IT?

 

WHAT IS IT?
- Atopic eczema is a condition that is genetically linked.

 

 

- In atopy there is an excessive reaction by the immune system, producing inflamed, irritated and sore skin.

 

 

- Other conditions that are associated with atopy include asthma and hayfever.

 

 

- About 60-70 per cent of children who have atopic eczema are virtually free of the condition by the time they reach their mid-teens (National Eczema Society, 2005).

 

 

- There is currently no cure for eczema despite extensive research into the condition.

 

 

INCIDENCE
- In the UK, up to one-fifth of all children of school age have eczema (National Eczema Society, 2005).

 

 

SYMPTOMS
- The severity of the disease can vary.

 

 

- In mild forms the skin is dry, hot and itchy.

 

 

- In more severe forms of atopic eczema the skin can become broken, raw and bleeding.

 

 

- The pruritus can be almost unbearable. As a result, constant scratching can also damage the skin, leaving it susceptible to infection.

 

 

MANAGEMENT
- Management involves minimising discomfort and distress. The mainstay of treatment is an effective skin care routine.

 

 

- Emollients are used to reduce water loss from the skin, preventing the dryness normally associated with eczema.

 

 

- During flare-ups, a steroid cream may be needed to help reduce inflammation.

 

 

- Oral steroids are sometimes prescribed in very severe cases of atopic eczema.

 

 

- New drugs called topical immunomodulators are now available for use in the treatment of the condition.

 

 

- Parents should be recommended to buy only cotton clothing and bedding.

 

 

- A non-biological washing powder should be used and fabric softeners avoided.

 

 

- Children’s nails should be kept short to reduce damage from scratching.

 

 

- During the day, distraction is often the best way to reduce the amount of scratching.

 

 

- At night, cotton mittens over children’s hands can be helpful in reducing damage to the skin during sleep.

 

 

- The role of diet in the management of eczema has not been proven. Generally, changes in diet are only considered in severe cases, when conventional treatments are failing.

 

 

EFFECTS ON THE FAMILY
- Living with eczema can mean constant scratching, cracked and often bleeding skin. Carers can feel helpless and exhausted through lack of sleep and worry.

 

 

- As many as 52 per cent of carers of children with eczema feel they have no control over their child’s condition.

 

 

- As a result of their child’s eczema, some 23 per cent of carers say they never get a good night’s sleep.

 

 

- As many as 15 per cent of carers of children which eczema feel that the whole household is disrupted.

 

 

- The whole family needs advice on the practical management of childhood eczema and coping strategies for daily life.

 

 

- Recognising the impact eczema can have on the family is the focus of this year’s National Eczema Week, 17-24 September 2005 (National Eczema Society, 2005).

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