Download Free Medical The Treatment And Management of Eczema PowerPoint Presentation

The Treatment And Management of Eczema PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : This medical presentation titled "The Treatment And Management of Eczema" provides information on eczema which is characterized by dry, itching and inflamed skin.

Tags : Treatment, Management, Eczema, dry, itching, inflamed skin, Types Of Eczema, Atopic Eczema, Discoid, Pompholyx, palmar, plantar, Irritant Contact, Allergic Contact, Erythrodermic, Treatment, Reduce inflammation, emollient, Topical Steroid, Topical Immunomodulators

Published on : Apr 25, 2021 | Views : 2591 | Downloads : 1

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

The Treatment And Management of Eczema Sharon Hulley Clinical Nurse Specialist in Dermatology University Hospital Of Wales, Cardiff
Slide 2-

What Is Eczema ? “Eczema is derived from the Greek ‘ekzein’ meaning ‘to boil over’ and is characterised by dry, itching and inflamed skin” (The Skin Care Campaign 1999)
Slide 3-

Types Of Eczema
Slide 4-

Atopic Eczema
Slide 5-

Atopic Eczema Increasing incidence Affects approximately 1:10 children Familial tendency Associated with asthma and hay fever
Slide 6-

Diagnostic Criteria For Atopic Eczema Inflammatory condition of the superficial skin, characterised by 3 or more basic features: pruritus lichenification chronic relapsing course Personal or family history of atopy (asthma, allergic rhinitis, atopic eczema Plus 3 or more minor features: e.g. xerosis, elevated serum IgE, early age of onset, itch when sweating Hanifin & Rajka (1980)
Slide 7-

UK Working Party’s Diagnostic Criteria Presence of itchy skin condition, plus 3 or more of the following: history of flexural dermatitis onset <2 years (if child is >4 years) personal or family history of asthma or hayfever visible flexural dermatitis Williams HC et al (1994)
Slide 8-

Diagnostic Criteria for atopic eczema (3) Must have an itchy skin condition (or reported scratching or rubbing in a child) plus 3 or more of the following : History of itchiness in skin creases such as folds of the elbows, behind knees, fronts of ankles or around the neck (or cheeks in children under 4 years) History of asthma or hay fever (or a history of atopic disease in a first degree relative in children under 4 years) General dry skin in the past year Visible flexural eczema (or eczema affecting the cheeks or forehead and outer limbs in children under 4 years) Onset in the first 2 years of life (not always diagnostic in children under 4 years) (McHenry et al 1995)
Slide 9-

Discoid
Slide 10-

Discoid Eczema Presents as well demarcated round oval or annular red scaly plaques. Can be vesicular and crusty or dry and scaly. Usually affects older people. Patients may also have a background of atopic eczema.
Slide 11-

ppt slide no 11 content not found
Slide 12-

Pompholyx (palmar/plantar)
Slide 13-

ppt slide no 13 content not found
Slide 14-

Irritant Contact
Slide 15-

ppt slide no 15 content not found
Slide 16-

ppt slide no 16 content not found
Slide 17-

Allergic Contact
Slide 18-

ppt slide no 18 content not found
Slide 19-

Erythrodermic
Slide 20-

Varicose / Venous
Slide 21-

ppt slide no 21 content not found
Slide 22-

Craquele / Craquelatum
Slide 23-

ppt slide no 23 content not found
Slide 24-

Aim Of Eczema Treatment To treat and control the symptoms of itching, pain and discomfort Reduce inflammation Replace lost moisture Inhibit scratching and thus infection Improve the quality of life for the patient and their family
Slide 25-

How Do We Treat Eczema? Moisturisers / Emollients (soap substitute, bath oil, topical) Ointment - dry skin Cream or lotion - wet skin Appropriate quantities
Slide 26-

Effects of an emollient 20 minutes after an emollient application Prior to emollient application
Slide 27-

How Do We Treat Eczema? Appropriate strengths of steroid
Slide 28-

Which Strength Of Topical Steroid ? Mild Eczema Mild - Moderate Moderate Moderate - Severe Severe 1% Hydrocortisone Clobetasone butyrate Betamethasone 0.025% Betamethasone / Mometasone Furoate 0.1% Clobetasol Proprionate
Slide 29-

How Do We Treat The Condition? Appropriate quantities of steroid
Slide 30-

The Finger Tip Unit 1 finger tip unit (ftu) = 0.5g
Slide 31-

Topical Steroid Quantities (child) Twice daily application of steroid all over: 6 month old = 9.5g daily = 66.5g weekly 4 year old = 19.25g daily = 134.75g weekly 7 year old = 24.5g daily = 171.5g weekly
Slide 32-

Topical Steroid Quantities (adult) Face & Neck 2 ftu = 1g Back & Front 7 ftu = 3.5g Arm 3 ftu x2 = 3g Hand (both sides) 1 ftu x2 = 1g Leg (not incl. foot) 6 ftu x2 = 6g Foot 2 ftu x2 = 2g total per once daily application = 16.5g Per week = 115.5g
Slide 33-

How Do We Treat The Condition? (cont’d) Bandages Antibiotics (topical / oral) Treatment regime Avoid provoking factors if possible
Slide 34-

What If That Doesn’t Work?
Slide 35-

Review treatment steroid not strong enough not enough emollient infection not addressed consider bandaging Topical immunomodulators
Slide 36-

NICE Recommendations For Use Of Topical Immunomodulators Treatment with both Protopic & Elidel must be initiated by physicians (including G.P’s) with a special interest and experience in dermatology. Prior to commencing - careful discussion with patients and/or parents of potential risks and benefits of all seconds-line treatment options.
Slide 37-

Mode Of Action Calcineurin inhibitors. Suppression of T-lymphocyte responses.
Slide 38-

Availability Of Protopic & Elidel Protopic (Tacrolimus) 0.03% & 0.1% Ointment 30g (0.03% & 0.1%) 60g (0.03% & 0.1%) Elidel (Pimecrolimus 1%) Cream 30g 60g 100g
Slide 39-

Licensed Indications For Protopic (Tacrolimus) 0.03% & 0.1% Ointment Children 2-16 years 0.03% Adults & adolescents over 16 years 0.1%. Treatment of moderate to severe atopic eczema unresponsive to conventional therapy.
Slide 40-

NICE Indications For Protopic (Tacrolimus) 0.03% & 0.1% Ointment Not recommended for the treatment of mild atopic eczema or as a first-line treatment. Treatment of moderate to severe atopic eczema in adults & children over 2 years of age. Failed response to topical corticosteroids. At risk of adverse effects from further use of topical corticosteroids e.g. skin atrophy.
Slide 41-

Application Of Protopic (Tacrolimus) 0.1% & 0.03% Ointment Prior to use, clinical infections at treatment sites should be cleared. Emollients should not be applied to the same area within 2 hours of applying tacrolimus. Body, limbs, face, neck and flexures. Twice daily for up to 3 weeks then reduce to once daily until clear. Restart as/when necessary.
Slide 42-

Side Effects More Common Burning or tingling sensation Pruritus Erythema Less Common Folliculitis Herpes simplex infection Acne Increased sensitivity to hot and cold Alcohol intolerance Lymphadenopathy has also been reported
Slide 43-

Licensed Indications For Elidel (Pimecrolimus) Cream Children over 2 years & adults. Acute treatment of mild to moderate atopic eczema (including flares).
Slide 44-

NICE Indications For Elidel (Pimecrolimus) Cream Not recommended for the treatment of mild atopic eczema or as a first-line treatment. Treatment of moderate atopic eczema on face & neck in children aged 2-16 years of age. Failed to respond to topical corticosteroids. At risk of adverse effects from further use of topical corticosteroids e.g. skin atrophy.
Slide 45-

Application Of Elidel (Pimecrolimus 1%) Cream Prior to use clinical infections at treatment sites should be cleared. Not to be applied to areas affected by acute cutaneous viral infections. Twice daily until symptoms resolve. Re-start as/when necessary.
Slide 46-

Side Effects More Common Burning sensation Pruritus Erythema Less Common Skin infections (including folliculitis and rarely impetigo, herpes simplex and zoster and molluscum contagiosum) Papilloma (rarely) Local reactions such as pain, paraesthesia, peeling, dryness, oedema and worsening of eczema