Atopic Eczema

Key points

• Atopic eczema: itchy, flexural dermatitis with personal/family atopy (asthma, hay fever); usually starts in childhood.
• Stepwise management: emollients (liberal, always) → topical steroids by potency/severity → topical calcineurin inhibitors (tacrolimus/pimecrolimus) for sensitive sites.
• Complications: bacterial infection (S. aureus), eczema herpeticum (HSV — punched-out erosions, EMERGENCY needing systemic aciclovir).
• Severe/refractory: phototherapy, systemic agents (ciclosporin, methotrexate, azathioprine, dupilumab).
• Cardiac-sounding link: none — but ichthyosis/severe dermatitis can cause high-output states (rare).

Decision points in this pathway

• Flaring?
• Monomorphic punched-out erosions + unwell?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.