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Author: Dr Diana Purvis, Paediatric Dermatologist, Starship Hospital, Auckland, New Zealand, September 2014.
Read these guidelines in association with:
The majority of children with eczema can be managed in an outpatient setting.
Treatment should be prescribed as a package including:
Prescribers need to spend time to ensure that children and their caregivers understand all aspects of therapy and how to use them.
Prescriptions for topical treatments should be supported with verbal instructions, written information (eg eczema action plan, handouts) and demonstration (eg videos). Education from an eczema nurse has been shown to improve adherence and the effectiveness of treatment.
Resources for families
Resources for prescribers include:
The benefits and harms of topical corticosteroids should be discussed with the family/caregivers, emphasizing that benefits outweigh possible harms when they are used correctly.
The potency of topical corticosteroids should be tailored to the child’s eczema:
Do not use super potent topical corticosteroids in children (or potent in children under the age of 12 months) without specialist dermatological advice.
If there is no improvement after 7–14 days of treatment then the following should be considered:
|Referral for specialist advice|
|Referral for inpatient care||
|Referral for eczema nurse advice||
|Referral for specialist dermatologist advice||
|Referral for psychological advice||
|Referral for specialist paediatric advice||
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