Angelite Nurses: Eczema

Eczema

General information

Atopic dermatitis, often the first sign of an allergic predisposition in a child; many later develop respiratory allergies
Usually manifests during infancy

Medical management

Drug therapy

Topical steroids
Antihistamines
Coal tar preparations
Cautious administration of immunizations
Medicated or colloid baths

Diet therapy: elimination diet to detect offending foods

Assessment findings

Erythema, weeping vesicles that rupture and crust over
Usually evident on cheeks, scalp, behind ears, and on flexor surfaces of extremities (rarely on diaper area)
Severe pruritus; scratching causes thickening and darkening of skin
Dry skin, sometimes urticaria

Nursing interventions

Avoid heat and prevent sweating; keep skin dry (moisture aggravates condition).
Monitor elimination diet to detect food cause.

Remove all solid foods from diet (formula only).
If symptoms disappear after 3 days, start 1 new food group every 3 days to see if symptoms reappear.
The food that is suspected of causing the rash is withdrawn again to make sure symptoms go away in 3 days and is then introduced a second time (challenge test).

Check materials in contact with child's skin (sheets, lotions, soaps).
Avoid frequent baths.

Add Alpha Keri to bath.
Provide lubricant immediately after bath.
Pat dry gently with soft towel (do not rub) and pat in lubricant.
Avoid the use of soap (dries skin).

Administer topical steroids as ordered (penetrate better if applied within 3 minutes after bath).
Use cotton instead of wool clothing.
Keep child's nails short to prevent scratching and secondary infection; use gloves or elbow restraints if needed.
Apply wet saline or Burrow's solution compresses.

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