Assessment of the Child with Eczema
Distribution of atopic eczema - The distribution of eczema tends to change with age. In infants, the face and scalp are prominently affected, although the trunk may be involved. In older children, the skin flexures (cubital and popliteal fossae) and frictional areas, such as the neck, wrists and ankles, are characteristically involved.
Causes of exacerbation of eczema
- Bacterial infection, e.g. Staphylococcus, Streptococcus spp.
- Viral infection, e.g. herpes simplex virus
- Ingestion of an allergen, e.g. egg
- Contact with an irritant or allergen
- Environment: heat, humidity
- Change or reduction in medication
- Psychological stress
Condition of the skin
- Distribution of the eczema: is the skin excoriated, weeping, crusted, lichenified?
- How troublesome is the itching?
- Worse or better than usual?
- What causes exacerbation — food or other allergens, irritants, medications, stress?
- Does it disturb sleep?
- Does it interfere with life?
- Family knowledgeable about condition and its management?
- Any evidence of infection — bacterial or herpes simplex virus?
- Problems from other allergic disorders?
- Is growth normal?
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