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Rmpeds.com

“DR. ART” QUINTANILLA, MD
Board Certified Pediatrician
Post-graduate Training:
Maimonides Children’s Center/State University of New York Downstate Medical Center,
Miller Children’s Hospital-Long Beach Memorial Medical Center/University of California at Irvine
35-900 Bob HopeDrive, Suite 140, Rancho Mirage, CA 92270
Tel: (760) 770-0000

• ATOPIC DERMATITIS / CHRONIC ECZEMA.
Atopic dermatitis is a chronic skin allergy condition defined by constant dry skin
and the presence of a red, extremely itchy rash , usually located on cheeks ,
and creases of elbows, wrists and knees , although it can spread to other areas
including neck , ankles and feet. This illness is usually inherited and may be
related to a history of asthma, hay fever, or a family history of eczema.
1) TREATMENT:
i)
Bathing and Skin hydration: this is the main way to prevent a “flare-up”;
your child should have one bath daily for about 10 minutes, remember
that water soaked skin is less itchy; avoid soaps and other irritants; soaps
may become necessary until adolescence and then Unscented Dove,
Lubriderm or Cetaphil skin cleansers could be used.
Lubricating Creams: these patient always have dry skin and lubrication is
very important, the lubricating cream should be applied after bathing over
the entire skin surface while it is damp, recommended lubricants are
Cetaphil, Keri, Nivea, Lubriderm and Nutraderm moisturizing creams.
Another excellent product, especially for older children and adolescents is
VANICREAM.
Steroid Creams: steroids are the main treatment for eczema and itching,
it must be applied according to the pediatrician’s instructions, especially at
the first sign of a “flare-up”.
Oral antihistamines: sometimes, prescription antihistamines such as Atarax
or Zyrtec may be helpful for relief of itching, but these medications are
not the main therapy.
2) PREVENTION:
i)
Breastfeeding is essential; otherwise hypoallergenic formulas will be a
good substitute, such as Nutramigen, Alimentum or Neocate.
Cotton clothes should be worn as much as possible; avoid wool fabrics and
clothes made from rough or scratchy materials.
Avoid triggers for eczema “flare-ups”, such as soaps, bubble baths, pool
chemicals such as chlorine, dry air (use a humidifier), excessive heat, or
excessive cold.
Keep your child off the grass during pollen season.
Keep your child away from anyone with fever blisters because Herpesvirus
can cause a serious skin infection.
Keep your child’s fingernails cut short.
Avoid certain food products that may be related to skin allergy and
eczema, such as cow’s milk and diary products in general, eggs, peanuts
and peanut butter, wheat cereal and whole wheat products, fish and
seafood, citrus juices an citrus in general, such as tomatoes.
Avoid products that can block the sweat glands and therefore worsen the
rash and itch, such as thick ointments, petroleum jelly, vegetable oils.

3) Call the office if:

The rash gets extremely red or itchy, and becomes raw looking.
The rash appears infected, i.e. yellow pus discharge, scabs, red
streak marks over the skin.
The child develops a fever or presents with fever blisters.
There is no improvement after 7 days.

Source: http://www.rmpeds.com/docs/Atopic_dermatitis.pdf