February Week 1: Eczema – Treatment & Management


Williams, H. Atopic Dermatitis. New England Journal of Medicine. June 2005. 352;22.

Case 1:

A 5 month old girl is brought in by mom for an acute visit for “dry skin.” She reports the girl’s cheeks are always red and irritated and she rubs them against the sheets and car seat whenever she can. She has tried moisturizers without improvement. One of her friends suggested the child might have eczema and she brought her in.

What is eczema? 
How is it diagnosed?
How will you treat this child? 
Mom is worried about the side effects of the treatment you recommend. What do you tell her? 
Mom wants to know what the chances are that her child will grow out of this. What do you tell her?
When would you treat with antibiotics? 
When would you refer to derm? When would you refer to allergy?

Case 2:

You are seeing an 18 month old for a well visit and mom points out several skin lesions on the child’s arms and legs. They appear to be round areas of erythema with scaling and cracked skin, each varying in size but ranging 1-3 cm in diameter. The child is in day care and has 2 older siblings in school.

What is in your differential diagnosis? What is the most likely?