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Abstract: The patient, a 35-year-old male, reported that he had been suffering from a skin condition for years, with itching all over his body whenever there was climate change and after exercise, with erythema, small blisters, and even yellow water dripping outward at every turn. Combining the patient’s medical history and test results, he was diagnosed with atopic eczema. After improving lifestyle and medication, the patient’s symptoms were relieved and his condition was controlled, and he expressed satisfaction with the treatment effect.
[Basic information] Male, 35 years old
Disease Type】Atopic eczema
Hospital】Guangdong Provincial People’s Hospital
Date of consultation】May 2022
Treatment plan】Lifestyle improvement + medication (Dupriumab injection + Klippolyol ointment) + potassium permanganate wet compress + Vaseline moisturizer
Treatment period】4 weeks of continuous treatment, regular weekly follow-ups
Treatment effect】Itching disappeared completely and most of the rash subsided
I. Initial consultation
The patient reported that for 20 years, she had been itching all over her body for a long time, with mild and severe rashes, and yellow mucus would ooze out in severe cases, mainly in the exposed areas such as the limbs. Although he had paid close attention to environmental hygiene and was careful not to eat any seafood such as fish, shrimp, or crab, the condition still recurred, especially during climate change or after exercise. He was diagnosed with eczema in several hospitals, and allergen testing showed elevated IgE and allergy to household dust mites and dust mites.
After coming to our hospital, skin examination revealed more red papules and thin patches of varying sizes distributed on the extremities, partly covered with dense small blisters with mucus exudation, and obvious dry skin on both lower legs. In view of the long duration of the disease, the obvious pruritic symptoms, the positive allergen-specific IgE, and the fact that the patient had suffered from allergic rhinitis, the patient was considered to have atopic eczema.
II. Treatment history
The patient said that he had been treated for eczema in several hospitals, using antihistamines and topical strong glucocorticoid ointment for a long time, but he felt that the effect was average, recurrence was frequent, and he was resistant to conventional treatment drugs. Now he is busy at work and often has to receive clients. He hopes to control the rash and itching symptoms as soon as possible, preferably to reach complete control, so that he can resume his normal life and social status.
The patient was then advised to do routine stool tests to initially rule out parasitic infections and then given a combination of Dupliximab injection subcutaneously, potassium permanganate wet compresses, and topical clitoral borrelia ointment. wet compresses were stopped after 1 week and topical clitoral borrelia ointment was stopped after 1 month. During this period, patients should improve their lifestyle, including avoiding strenuous exercise, wearing loose cotton clothing as much as possible, and using emollients such as Vaseline emollient cream immediately after bathing to promote recovery.
III. Effectiveness of treatment
Patients were seen at 1-week intervals. At the first follow-up, the patient reported that the pruritic symptoms were basically relieved, most of the rash subsided, blisters and ooze disappeared completely, but the skin was still dry and in good physical condition. At the fourth follow-up visit, the rash on the patient’s body basically disappeared, and there were no abnormal symptoms such as crusting and pus flow. Due to the improvement of the bad physical symptoms, the patient was gradually relaxed and happy, and expressed satisfaction with the treatment effect.
IV. Precautions
As a doctor, I am truly happy for the patient because the discomfort is gradually relieved and the body is gradually recovering after improving the living habits and active medication treatment. Since atopic eczema often recurs, patients need to pay attention to avoid irritating factors in life, including physical and chemical environmental stimuli such as strenuous exercise, temperature and sweating; avoid stimulation by allergic factors such as dust mites; and avoid unreasonable use of alkaline soaps and cleansers, which can damage the skin barrier and lead to bacterial or viral infection of the skin. In daily care, topical moisturizing emollients are the basic treatment for atopic eczema, so patients are advised to apply them regularly.
V. Personal insights
Atopic eczema must be treated for as long as possible to control symptoms, reduce recurrence, and improve the quality of life of patients. In addition to assessing the severity of the disease, we should also communicate with patients in depth to understand their psychological needs and develop individualized treatment plans, taking into account the actual situation of the disease and financial ability, in order to improve patient compliance and achieve the treatment goals of long-term symptom control and reduction of recurrence.