Page 46 - LECTURE NOTES

months up to 2 years), childhood atopic eczema (from 2 years to 10 years) and atopic

eczema of adolescents and adults.

Infantile Atopic eczema

Atopic dermatitis usually starts in the first year of life. During this phase, there is facial

erythema, vesicles, oozing and crusting located mainly on the face, scalp, forehead and
extensor surface of the extremities. Buttocks and diaper area are frequently spared.

Childhood eczema:

The lesions tend to be drier and scaly. Flexor surfaces and skin creases are
predominantly involved. Facial lesions with eyelid involvement and lesions around the

neck also occur. Lichenification from chronic itching and scratching occur over flexor

surfaces. Psychological effects often are very prominent

Adolescent and adult atopic dermatitis:

Flexural predilection of lesions persists. Localized, eczematous or lichenified plaques

often predominates the clinical picture. Prurigo papules and nodules tend to occur.

Resolved cases show dryness and irritability of the skin with a tendency to itch with
sweating and other triggers. Recurrent and persistent hand dermatitis is a frequent

feature.

TREATMENT

General Measures
9 Counseling; that it is not curable but controllable by treatments;

9 Avoidance of factors that promotes dryness, itching or inflammation, such as

excessive bathing and exposure to volatile chemicals (gasoline, kerosene)
9 Avoidance of contact with local irritants like woolen garments; use soft cotton

garments.

9 Clothing and linens should be washed in mild detergents and rinsed well.
9 Soaps should be used when they are necessary

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