Exploring the biopsychosocial impact of recalcitrant eczema - a case report

Introduction: A 13-year-old female patient presents with a complex case of severe eczema ongoing for over a year. This case report integrates the biopsychosocial model, focusing on the biological, psychological, and social determinants affecting flare onset and guiding the treatment plan. Methods: Consent was obtained from the patient and her mother. A comprehensive review of the patient's medical file, including past medical and surgical history, family, and social history was conducted. A multidisciplinary approach drawing on opinions from dermatology, primary care, and social work, was used to optimize treatment. Results: Through a biological perspective, the patient has widespread excoriation and lichenification throughout the body, likely attributed to hormonal changes associated with menarche and family history. Psychologically, the patient described a shift from her previously calm demeanor to a more agitated and anxious state. Socially, the patient reports social withdrawal and the stigma associated with her flares. Discussion: This case highlights the importance of incorporating the biopsychosocial model when treating severe and relapsing cases of eczema in pediatric populations. Dealing with chronic, worsening flares, as reported in the case, highlights the vital need for a multidisciplinary approach to address the emotional and physical impacts. Conclusion: The patient's case represents a common pediatric presentation in general practice and illustrates the necessity of incorporating the biopsychosocial model when addressing treatment options for chronic skin conditions such as eczema.