n CME : Your SA Journal of CPD - Evidence-based treatment of atopic eczema in general practice : main topic

Volume 21, Issue 9
  • ISSN : 0256-2170



Atopic eczema (AE) is a common chronic condition characterised by a dry, itchy skin, associated with flares and remissions. <br>The exact cause of AE is unkown, but a combination of genetic and environmental factors probably interacts. The importance of the latter is emphasised by the observation of an increased incidence in relatives who have moved from a rural to an urban environment. <br>The clinical presentation varies according to the age of the patient. Many remedies are usually tried by both the patient and the doctor, but we only consider treatments based on evidence from randomised controlled trials (RCTs). <br>Practical management consists of the correct diagnosis, moisturising the skin with aqueous cream or petroleum jelly, topical steroids and wet wraps in acute flare-ups, and the use of the newer macrolide treatments in patients with moderate to severe AE. However, use of the latter is limited by cost and availability. <br>Breast-feeding by a mother with a history of atopy may go some way towards preventing a child from developing eczema later in life. <br>The usefulness of antihis tamines to prevent itch has not been proved beyond doubt, nor has that of evening primrose oil.

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