Eczema is an intensely itchy inflammatory skin condition that occurs more than once in many children. Scratching due to itching can lead to skin damage and infection, often causing discomfort for the affected child and panic for the parents. Atopic dermatitis is a common cause of eczema, causing mainly erythema, itching, fever, pain, and even small blisters on the skin. Research suggests that eczema has a genetic predisposition, that about half of children with eczema may have hay fever or asthma, and that family members of children with eczema often have hay fever, asthma or other allergic conditions. Eczema itself is not an allergy, but allergic reactions can induce eczema, and some environmental factors can trigger eczema. About 10-20% of children suffer from eczema, with typical symptoms appearing mostly in the first few months of life and improving by age 5. Clinical manifestations of eczema The symptoms of eczema are highly variable in the early years. In children 2-6 months of age, eczema mainly presents as itchy, dry, red patches and small blisters on the cheeks, forehead, and head. The rash may extend to the arms, legs, and trunk, and lesions may appear in the affected areas, as well as in the crooks of the elbows, n-folds, or ankles and back, with crusting, scaling, and peeling as the inflammation decreases. In older children, the rash is generally more crusty and the dryness and pruritus of the skin more severe, and these symptoms may worsen or improve with periodic episodes. Patients often think that scratching will reduce itching, but scratching can worsen itching and even lead to thickening and hyperpigmentation of the skin. For this reason, eczema is often called “pruritic rash” rather than “rash itch”. Duration of eczema The symptoms of eczema tend to resolve or disappear within a few months or years, with most children starting to improve by the age of 5-6 years. Some children whose symptoms have improved may have a relapse after entering adolescence due to irritation of the skin from hormones, stress, use of cosmetics, etc. However, eczema is not a contagious disease and does not require isolation of the affected child from other children. Prevention of eczema Some people believe that since eczema is genetic in origin, there is no way to prevent it. However, specific triggers can exacerbate eczema symptoms, so avoiding them can prevent and improve recurrence of symptoms. Possible triggers include pollen, mold, dust, animal fur, cold air, dry skin, soaps and detergents, artificial fibers, certain skin care products, perfumes, tobacco smoke, foods (e.g., eggs, soy, nuts), psychological stress, heat, and sweat. Also, preventing scratching can prevent the rash from getting worse and lesions from developing. Diagnosis of eczema The diagnosis of eczema is difficult because each child with eczema presents with very different symptoms and is easily confused with other skin diseases, and there are no specific tests. The differential diagnosis includes seborrheic dermatitis, psoriasis, and contact dermatitis. Medical history, family history, history of asthma or other allergic diseases can provide useful clues. The lesions of eczema are polymorphic, predominantly erythematous, papular, and papular rashes, ill-defined, diffuse, and with a tendency to exude. The course of the disease is irregular and recurrent, with more pronounced pruritus. Skin patch tests and prick tests help to identify possible allergens. Treatment of eczema The most common treatment for eczema is topical application of glucocorticoids, which are applied to the affected area twice daily. There are many types of topical hormones and they should be used under medical supervision. Hormone preparations of different dosage forms and strengths should be selected according to the patient’s age, the nature of the lesions, the location and the extent of the disease, in order to control inflammation and reduce symptoms quickly and effectively. In principle, systemic hormone therapy should be used as little as possible or not at all. Patients with serious conditions that are difficult to be controlled by other drugs can be applied for a short period of time, and the dosage should be reduced in time after the condition improves. Topical NSAIDs have antipruritic effects and can also be used as an alternative to hormone therapy or in combination with hormones. Other prescribed medications include antihistamines to control itching and oral or topical antibiotics to prevent or treat secondary infections. UV therapy may also be considered in older children, but whole-body UV therapy should be avoided in children under 6 years of age.