Fortnightly Review: Management of atopic eczema

Summary points Time for explanation and education is essential Adequate amounts of emollients should be prescribed, and these should be used liberally and frequently When prescribing topical corticosteroids the age of the patient, the site to be treated, and the extent of the disease are important considerations Deterioration in previously stable eczema may be due to secondary bacterial or viral infection or to development of a contact dermatitis Attempts to eradicate the house dust mite are not currently recommended Dietary restriction is of little or no benefit in adults, and in children it is worth trying only in selected infants under professional supervision Evidence for the therapeutic value of evening primrose oil remains inconclusive PUVA or UVB may be helpful in selected patients