Fortnightly Review: Management of atopic eczema

BMJ 1995;310:843-847 (1 April)

Education and debate

Fortnightly Review: Management of atopic eczema

P M McHenry, clinical lecturer,^a H C Williams, senior lecturer,^b E A Bingham, consultant dermatologist,^c on behalf of a Joint Workshop of the British Association of Dermatologists and the Research Unit of the Royal College of Physicians of London

^a Department of Dermatology, Robertson Building, University of Glasgow, Glasgow G12 8QQ, ^b Department of Dermatology, University Hospital, Queen's Medical Centre, Nottingham, ^c Department of Dermatology, Royal Victoria Hospital, Belfast

Participants in the workshop are listed at the end of the article.Correspondence to: Dr McHenry.

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

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