pruritus

Typical features
-pruritus
-facial and extensor involvement in infants and young children
- flexural lichenification in older children and adolescents
- chronic or relapsing dermatitis
-personal or family history of Atopic disease
Clinical :
Erythematous papules associated with excoriations, vesiculation, and serous exudate, thickened skin with accentuated markings /lichenification and fibrotic papules. It may be secondarily infected with candida.
Treatment:
-avoidance of irritants such as detergents, chemicals, and abrasive materials as well as extremes of temperature and humidity is important in managing this disease.
-avoidance of food allergens: eggs, milk, peanuts, soy, wheat, and fish, etc.
- patients with Atopic dermatitis have evaporative losses due to a defective skin barrier. Appliying a wet facecloth or towel to the involved area for 15-20 minutes
-an effective emollient combined with hydration therapy will help skin healing and can reduce the need for topical corticosteroids. Petroleum jelly / vaseline is effective. Moisturizers often need to be applied several times daily .
-corticosteroids can decrease s aureus colonization. discontinued when inflammation resolves.
-calcineurin inhibitors: its immunomodulatory agents that inhibit the transcription of proinflammatory cytokines as well as other allergic mediators and target key cells in allergic inflammation.
-anti-infective therapy : mupirocin, cephalosporin.
-antipruritic agents: antihistamines, anxiolytics.