Dismissing the fallacies of childhood eczema management: case scenarios and an overview of best practices

Article Details

Authors
Kam Lun Hon MBBS, MD (CUHK), FAAP, FCCM, Kin Fon Leong MBBS, MRCPCH, Theresa Leung MBBS, FRCPCH, FHKAM(Paed), FHKCPaed, Alexander KC Leung MBBS, FRCPC, FRCP(UK & Irel), FRCPCH, FAAP

Article Type
Review

DOI
10.7573/dic.212547

Related Articles

Article Page

Abstract

Background: Eczema or atopic dermatitis (AD) is a common relapsing childhood dermatologic illness. Treatment of AD is primarily topical with emollients and corticosteroid/calcineurin inhibitor, which is efficacious for the majority of patients. However, AD is often complicated and difficult to manage in many Asian cities. Effective therapy is impeded by fallacies in the following aspects: (1) mistrust and unrealistic expectations about Western medicine, (2) skin care and allergy treatment, (3) ambiguity about optimal bathing and moisturizing, (4) hesitation and phobias about the usage of adequate topical corticosteroid and immunomodulatory therapies, (5) food and aeroallergen avoidance and dietary supplementation, and (6) complementary and alternative therapies.

Methods and Results: Eleven anonymized case scenarios are described to illustrate issues associated with these fallacies. A literature review is performed and possible solutions to handle or dismiss these fallacies are discussed.

Conclusions: The first step in patient care is to accurately assess the patient and the family to evaluate possible concerns, anxiety, and phobias that could impede therapeutic efficacy. Education about the disease should be individualized. Conflicting recommendations on the usage of topical steroid have a detrimental effect on management outcomes, which must be avoided.

Keywords: atopic dermatitis, dietary supplementation, eczema, fallacies, food avoidance, moisturizer, steroid phobia.

Citation: Hon KL, Leong KF, Leung TNH, Leung AKC. Dismissing the fallacies of childhood eczema management: case scenarios and an overview of best practices. Drugs in Context 2018; 7: 212547. DOI: 10.7573/dic.212547

Contributions: Hon is the principal author with contribution of anonymized cases; Leong and Leung T also contributed cases. Leung A is the senior author who helped in editing and proofreading the manuscript.

Disclosure and potential conflicts of interest: The authors declare that there is no conflict of interest in preparing this article. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors are available for download at https://www.drugsincontext.com/wp-content/uploads/2018/09/dic.212547-COI.pdf

Acknowledgments: None.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2018 Hon KL, Leong KF, Leung TNH, Leung AKC. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2018 Hon KL, Leong KF, Leung TNH, Leung AKC. https://doi.org/10.7573/dic.212547. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/dismissing-the-fallacies-of-childhood-eczema-management-case-scenarios-and-an-overview-of-best-practices

Correspondence: Kam Lun Ellis Hon, Department of Paediatrics, The Chinese University of Hong Kong, 6/F, Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong. ehon@cuhk.edu.hk

Provenance: invited; externally peer reviewed.

Submitted: 21 June 2018; Peer review comments to author: 29 August 2018; Revised manuscript received: 3 September 2018; Accepted: 4 September 2018; Publication date: 3 December 2018.

Drugs in Context is published by BioExcel Publishing Ltd. Registered office: Plaza Building, Lee High Road, London, England, SE13 5PT.

BioExcel Publishing Limited is registered in England Number 10038393. VAT GB 2527720 07.

For all manuscript and submissions enquiries, contact the Editor-in-Chief gordon.mallarkey@bioexcelpublishing.com

For all permissions, rights and reprints, contact David Hughes david.hughes@bioexcelpublishing.com

Download free full text PDF