Subacute - erythema, dry/flaky skin, crusted
Chronic - lichenified skin
Epidemiology
- 40% of population have an episode associated with atopy
- Atopic individuals have a tendency to
- Asthma
- Eczema
- Hay fever
- Allergic rhinitis
Aetiology
- Genetic-polygenic
- Environmental triggers
- Detergents/chemicals
- Infection
- Stress/anxiety
- Animal fur
- Foods (dairy products in the very young)
Clinical features
- Itchy erythematous scaly patches
- Often flexural
- May be associated with nail pitting
Investigations
- May have raised IgE or eosinophils
- Skin-patch testing
Management
- Education and explanation
- Avoid irritants
- Emollients, bath oil or soap substitutes
- Topical steroids or immunomodulators (tacrolimus)
- Antibiotics for secondary infection
- Antihistamines
- Second-line agents
- Ultraviolet (UV) light
- Oral steroids
- Ciclosporin/azathioprine
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