BACKGROUND: Eczema is a skin condition characterized by redness, itching, rashes and other symptoms. There is no cure.
Eczema is very common among young children, affecting as many as 10 percent of children under age 5. Many of those children outgrow the condition, but while they are affected, they are presented with special medical challenges. Children, especially very young children, won't stop scratching. They must be bathed in lukewarm water for short periods with mild soap or non-soap cleansers recommended by a doctor.
Special care must be taken to pat the skin almost dry, then apply moisturizing cream or ointment within minutes of the bath. By keeping a child's fingernails short, parents can help avoid the infections that can occur when scratching breaks the skin's surface, making it vulnerable to germs.
Parents must also follow specific rules about types of fabric in clothing, temperature of rooms in the house, mattresses and bedding fabric, and pets. Even stress can make eczema worse, and experts recommend keeping the same routine for children. They feel calmer and the schedule reinforces the regular routine of bathing and applying treatment to the skin.
CURRENT TREATMENTS: Moisturizers help keep the skin from cracking or itching and make children feel more comfortable. Also, because well-moisturized skin is less likely to crack, it helps keep out germs that cause infections. Creams containing steroids are the traditional treatment for eczema. Topical corticosteroids, such as over-the-counter hydrocortisone, help reduce inflammation. However, parents' fear of side effects, such as damage to the skin, makes their use problematic for patients and their doctors.
NEW TREATMENT: The Food and Drug Administration has approved a new, steroid-free prescription medication called elidel for the treatment of eczema. In clinical studies, elidel has been shown to significantly relieve the itch, along with the inflammation of eczema, within one week. The study results were published in the Journal of the American Academy of Dermatology in April 2002.
According to the elidel Web site, the most common side effect who a feeling of warmth or burning where the cream was applied, which was mild and went away within a few days. Patients also experienced headaches and cold-like symptoms. Elidel can be applied to treat active inflammations, or at the first sign of eczema. Lawrence Eichenfield, M.D., from Children's Hospital Adolescent Dermatology, San Diego, say this helps patients maintain a disease-free lifestyle by treating both conditions.
One of his patients, Megan Birnbaum, participated in one of the first clinical trials and helped get FDA approval for elidel. Megan's mother, Barbara Birnbaum, says applications of the cream at the first sign of skin irritation has meant an end to long-sleeved shirts and leggings for Megan to stop her from constantly scratching.
FOR MORE INFORMATION, PLEASE CONTACT:
Pediatric and Adolescent Dermatology
8010 Frost Street, Suite 602
San Diego, CA 92123
(858) 576-1700 x3886
http://childrensspecialists.com or www.chsd.org
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