atopic%20dermatitis
ATOPIC DERMATITIS
Atopic dermatitis or atopic eczema is a chronic, relapsing, familial, symmetric and pruritic inflammatory skin disease that commonly presents during early infancy and childhood, but can persist or start in adulthood.
It is commonly associated with elevated serum immunoglobulin E levels and a personal or family history of allergies, allergic rhinitis and asthma.
It is one of the most common skin diseases afflicting both children and adults.

Patient Education

  • Discuss the chronic nature of atopic dermatitis, exacerbating factors and appropriate treatment options
    • Emphasize that atopic dermatitis tends to decrease with increase in age
  • Convey the goal of treatment is control rather than “cure”
  • Discuss that many factors probably contribute to flare-ups and usually a specific cause cannot be found
  • Educate the patient about proper skin care (eg bathing, hydration and use of moisturizers)
    • Patient/caregiver should be instructed to apply emollients liberally 3 minutes after taking a bath 2-3 times daily or frequently as the skin gets dry even in the absence of symptoms
    • Studies showed that correct & adequate instructions for use & application of moisturizers when done properly reduces disease severity & overall topical corticosteroids use
  • Explain potential side effects of medications when used over extended periods of time
    • Apply topical steroid 10-15 minutes after application of emollients
  • Keep fingernails trimmed short
  • Use of cotton gloves at night to limit scratching
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Stephen Padilla, 26 Nov 2018
A 10-year retrospective study at Singapore General Hospital (SGH) has shown that majority of patients with tinea unguium, a common nail infection, are aged ≥60 years. In this cohort, patients of Indian and other ethnicities are over-represented for tinea unguium compared to Chinese and Malay patients.