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Winter 2007

UCLA Clinic Focuses Attention on Eczema in Children

Like other allergic diseases, atopic dermatitis—also called eczema—is becoming increasingly common among children: An estimated 15 percent of children are diagnosed with the chronic skin disorder, with symptoms commonly beginning in infancy, and in most cases appearing by age 2.

Eczema usually starts with some mild patches on the face or in the folds of the arms or behind the knees. Mild manifestations include redness and scaling; in more severe cases, it covers much of the body. The dry skin can become so irritated, especially from scratching, that the skin can break, leading to infections.

Certain foods, including eggs, milk, peanuts, soy and wheat, are often associated with the immunological reaction that triggers these symptoms, particularly in infants; common allergens such as dust mites and dander from furry animals can also be responsible. A skin or blood test will often reveal the culprit. “In more than 70 percent of patients with eczema, we can detect a food allergy,” says Maria Garcia-Lloret, M.D., a UCLA pediatric allergist and immunologist. Avoidance of foods that cause the allergic reaction can be helpful, she explains, but it must be accompanied by intensive skin treatment and avoidance of other triggers. Chemicals, fragrances and certain fabrics such as wool or synthetics can all exacerbate the problem, as can infections caused by bacteria getting into the open skin. Heat also tends to worsen the symptoms, so parents are urged to keep room temperatures cool.

The first line of treatment for eczema is to keep lubricated with simple skin creams. “We recommend daily bathing with just a little bit of simple soaps to get rid of the bacteria on the skin, followed by topical medications,” says Robert L. Roberts, M.D., who heads the UCLA Pediatric Skin Allergy/Eczema Clinic. For more severe cases, a short regimen of topical steroids or other anti-inflammatory medications may be warranted. Most children outgrow the condition by age 3 years, but proper care of eczema can help prevent progression to other allergic problems.

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