Author: Dr Ian Coulson, Consultant Dermatologist and Editor-in-Chief (2025).
Edited by the DermNet content department.
This boy had atopic eczema when he was younger. He has now got an itchy, weeping area on his medial calf and shin. Treatment with oral flucloxacillin has only partially helped.
There is a well-circumscribed plaque showing erythema, scale, oozing, and crust.
Given his previous history of atopic eczema, this is likely to be discoid eczema.
Treatment requires a potent or superpotent topical steroid, often with an admixed topical antibiotic or a systemic oral anti-staphylococcal agent (eg, flucloxacillin, erythromycin). If the lesions are particularly exudative, they can be dried with a 1 in 10,000 diluted potassium permanganate solution, applied to the lesion for 5 to 10 minutes, followed by a potent topical steroid.
If scratching and excoriation are problematic, the potent steroid can be covered with a paste bandage to minimise scratching and potentiate its effect in the short term.
