Intended for healthcare professionals

Practice A Patient’s Journey

Adult atopic eczema

BMJ 2011; 342 doi: (Published 14 March 2011) Cite this as: BMJ 2011;342:d644
  1. John Fuller, patient1,
  2. Andrew Wright, consultant dermatologist2
  1. 1Shipley
  2. 2St Luke’s Hospital, Bradford BD5 0NA
  1. Correspondence to: J Fuller somersettalk{at}
  • Accepted 19 October 2010

In the 13 years since his eczema returned, John has tried the full panoply of treatments and been admitted to hospital many times; he recognises that his is an exceptional case

Just after I graduated from university, my eczema returned. I had been hospitalised with the skin condition as a child, and it had disappeared suddenly before my teens. When it came back, I immediately recognised the telltale sign of an unbearable itch, which initially limited itself to the crooks of my elbows and the backs of my knees.

My general practitioner’s treatment regimen of emollients and an ever increasing strength of topical steroids failed as the eczema spread all over my body. My overwhelming early feelings were of anger, helplessness, and dread. I felt the eczema wasn’t being treated aggressively enough but knew there was no magic cure and that I might have to live with it for the rest of my life.

I was diagnosed with severe atopic eczema, and my health quickly worsened through a combination of habitual scratching and a barrage of infections that exacerbated the condition. I thought nothing of ripping at my skin continually until the blood was flowing and I was exhausted and in too much pain to continue. My skin was forever dry, inflamed, and covered in open wounds.

I endured a broad range of symptoms in that first year of my relapse, learning all the spiteful ways that atopic eczema can manifest itself. Weeping eczema ruined bedding, stuck to clothes, and was a cloying, unpleasant reminder. Yellow crusting meant infected eczema, which required antibiotics. Inflamed hair follicles caused white, painful spots all over my legs. Meanwhile, I derived a perverse pleasure from picking and scratching at wounds that hadn’t healed.

Admitted to hospital

I finally saw a dermatologist who fast tracked my admission to …

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