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ECZEMA: Atopic eczema in children - picture quiz

MODULE SUMMARY

Atopic eczema (atopic dermatitis) is a chronic, inflammatory skin disorder which develops in genetically-susceptible individuals in response to irritants and allergens. It can affect people of any age, but presents most frequently in childhood.1 

Dry, itchy skin can pose a considerable psychological and physiological burden but with the correct treatment advice, health professionals can enable parents and carers to alleviate children’s symptoms and achieve long-term control. This picture quiz will reinforce your understanding of atopic eczema and the appropriate treatment regimens for children.

AUTHOR(S)

Written by: Karen J Stocker BSc (Hons)
Reviewed by: Emma Williams RN (Child) Dip, Cert Ed, MSc EPP


NEXT STEPS

  • Read the clinical summary
  • Complete the picture quiz
  • Receive CPD certificate

 

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    Pre-learning reflection

    Please take a moment to answer these pre-learning questions. Once completed, click 'next step' below to start this picture quiz.  These answers will be logged on your CPD certificate which will be emailed to you on completion as evidence of your learning.


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    Clinical summary

    Atopic eczema can cause considerable distress. The main symptom is dry, itchy skin. It results from a defective epidermal barrier which allows irritants and allergens to enter and trigger the development of eczematous lesions. These lesions can appear as poorly demarcated area of redness, fluid-filled blisters, scaling or crusting. In severe cases, the skin may crack and bleed. During infancy, the lesions typically appear on the cheeks and extensor surfaces of the limbs, occasionally the trunk, but rarely the nappy area. In older children, the lesions favour the flexures. However, in children of Asian, black Caribbean and black African descent, the lesions often affect the extensors as well as the flexures.

    NICE guidelines for treating atopic eczema in the under-12s, advise a stepped approach which tailors treatment to the severity of the eczema.2 Emollients should always be used at least twice daily, even when the skin is clear. Liberal application in smooth strokes over the whole body helps to restore and maintain the defective epidermal barrier. Children need 250-500 g of unperfumed emollient every week. They should avoid soap and detergent-based wash products which can be extremely damaging to eczematous skin, and replace these with emollient wash products suitable for children with eczema. Other treatments may be added to the treatment regime according to the severity of the eczema.

     

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    Stepped approach to treating atopic eczema

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    Question 1

    There is no diagnostic test for atopic eczema. Diagnosis is based on visual assessment and patient history. Which of these is typical of atopic eczema? (Select all that apply).

     

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    question1b

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    question1c

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    Question 2

    This little boy’s eczema regularly flares. His skin appears to be clear at the moment.
    What treatment advice should you give?

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    Question 3

    Which skin condition is this most likely to be?

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    Question 4

    What severity of eczema would benefit from emollient treatment? (Select all that apply).

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    Question 5

    What additional treatment should be advised for a child presenting with widespread areas of rapidly worsening, painful eczema, with clustered blisters and punched-out erosions?

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    Post-learning reflection

    Please take a moment to answer these post-learning questions.  Once completed, click 'next step' below to start this picture quiz.  These answers will be logged on your CPD certificate which will be emailed to you on completion as evidence of your learning.


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