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Atopic dermatitis in infancy — RACGP Fellowship MCQ

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HardPaediatrics and adolescentAtopic dermatitis in infancyRACGP Fellowship

A 7-month-old has moderate atopic dermatitis affecting the cheeks and flexures despite regular fragrance-free emollient. There is no crusting, fever or other evidence of infection. The parents fear topical corticosteroids. What is the best next treatment?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Apply low-potency topical corticosteroid to active facial eczema for flare control

Explanation lettering: B = shown as A · C = shown as B · D = shown as C · A = shown as D

A is correct. An appropriately selected low-potency topical corticosteroid applied to active facial eczema, alongside continued generous emollient use and clear quantity instructions, is effective and safe when used correctly. B removes essential barrier therapy. C exposes an infant to systemic harms and is not routine maintenance. D uses excessive potency and duration on thin facial skin. E does not treat the underlying inflammation and is unnecessary without infection. Addressing corticosteroid phobia is part of treatment because undertreatment perpetuates inflammation, sleep disruption and secondary infection risk.

Reference: Australian Prescriber: Treatments for atopic dermatitis: https://australianprescriber.tg.org.au/articles/treatments-for-atopic-dermatitis.html