ECZEMA

(Dermatitis)

Acute or chronic superficial inflammation of the skin

Cause

  • Allergic dermatitis: reaction to food, chemicals, plants, jewellery or other substances
  • Atopic dermatitis: unknown cause

Clinical features

  • Vesicles (acute stage)
  • Itchy rash with dry rough scaly skin
  • Oozing due to secondary bacterial infection, causing regional lymphadenopathy and fever

Differential diagnosis

  • Seborrhoeic dermatitis
  • Tinea corporis

MANAGEMENT

  • Remove/avoid cause if known
  • Apply betamethasone cream 0.1% every 12 hours for 2 weeks on affected parts, EXCEPT the
    face and genital areas
  • If face or genitalia affected, apply hydrocortisone cream 1% every 12 hours for 2 weeks
  • Give an antihistamine to relieve itching; chlorphenamine 4 mg every 8 hours
    Child: 1-2 mg per dose
  • OR promethazine 25 mg at night; increase frequency to every 12 hours if necessary
    Child: 1 mg/kg daily in 1-2 divided doses

If secondary bacterial infection

Prevention

  • Avoid contact with allergens