Download Infected eczema - GP Resource Centre

Paediatric Dermatology
Dr Olivia O’Gorman Lalor
Atopic eczema
Typical distribution
(face, scalp, neck,
flexures, limbs, trunk)
Complication eg infection
Allergen?
Emollients
Topical steroids
intermittently
Topical tacrolimus
Chronic lichenified
eczema
Atopic eczema
Chronic scratching
causing lichenification
Identify any allergens
Emollients
Topical steroids
Wet wraps
Topical tacrolimus
Infected eczema
 Secondary bacterial
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infection eg
staph/strep
Swab for MC & S
Oral antibiotics
Potent topical steroid
Emollient
Infected eczema
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Eczema herpeticum
Herpes simplex
Swab: MC & S, viral
Oral aciclovir
Emollients
+/- cover for coexisting bacterial
infection
Topical steroid
subsequently
Discoid (nummular) eczema
Tinea corporis
Seborrheic dermatitis
Cradle cap
Generally less itchy than eczema,
often at flexures
Emollients
Topical antifungal + mild steroid
Psoriasis
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Confluent erythema
some scaling
clear demarcation
extends into skin creases
Irritant dermatitis vs candidiasis
Candidiasis
Irritant nappy dermatitis
sparing of creases
No sparing of creases
Satellite lesions
Impetigo
 Usually staphylococcus
 Swab to confirm/for
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sensitivities
Oral antiobiotic +/- topical
antibiotic with topical
steroid
Repeat antiobiotic course
often needed
Antiseptic emollient wash
Nasal swab/screen family
for recurrent infections
Scabies
 Itchy papulopustular

and vesicular eruption
Acral/genital
involvement common
Molluscum contagiosum
Eczematous
reaction
association with
Molluscum
lesions
Very common skin infection
by pox virus
Lesions spontaneous resolve
after months, often following
inflammatory phase
Inflammatory linear
verrucous epidermal
naevus (ILVEN)
Lichen striatus
Capillary haemangioma
 Variable size, can be
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multiple
Spontaneous resolution
usual
Treatment for large
lesions/if at critical sites
Systemic steroids/
intralesional
steroids/laser
Sebaceous naevus
Usually present from birth, more warty with time.
Basal cell carcinoma risk in one third
Port wine stain
Cutanous mastocytosis/urticaria pigmentosa