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Atopic Eczema — SCE Dermatology MCQ

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EasyPaediatric DermatologyAtopic EczemaSCE Dermatology

A 2-year-old child presents with itchy eczematous lesions on the cheeks, extensor aspects of the limbs, and trunk. There is no flexural involvement. The parents have a history of asthma and allergic rhinitis. According to NICE guidelines, what is the appropriate first-line emollient strategy?

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Correct answer: A — Apply emollients at least twice daily as a leave-on preparation

NICE guidelines for atopic eczema recommend emollients should be applied liberally and frequently, at least twice daily as leave-on preparations. They should be continued even when the skin is clear. Aqueous cream is NOT recommended as a leave-on emollient as it contains sodium lauryl sulfate (SLS), which can irritate atopic skin and impair the skin barrier. The distribution described (cheeks, extensor surfaces in an infant/toddler) is typical of infantile atopic eczema. Emollients should be applied before topical corticosteroids.

Reference: NICE 2007 CG57 Atopic eczema in under 12s (updated 2023)