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Applying NICE Guidelines for Atopic Eczema in Maltese Children

Author(s): Chris Sciberras | Chantal Fenech | Jonathan Mamo | Nicholas Mamo

Journal: International Journal of Collaborative Research on Internal Medicine & Public Health
ISSN 1840-4529

Volume: 3;
Issue: 3;
Start page: 196;
Date: 2011;
Original page

Keywords: NICE Guidance | Eczema | Atopic Eczema

Background: Atopic eczema is a pruritic inflammation of the epidermis and dermis, often occurring inassociation with a personal or family history of hay fever, asthma or allergic rhinitis. NICErecommendations help in the diagnosis and the holistic approach to the management of eczema.Aim & Objectives: To investigate the relationship between care and actual use of NICE guidelines incare given to children presenting with eczema.Method: Data was collected from paediatrics clinics using a questionnaire. The prevalence rates foreczema in Maltese children were calculated, together with the sex prevalence and the rates of associatedfamily history of allergies. NICE guidelines for the management of eczema in Maltese children wereoutlined and addressed to the Maltese paediatric population.Results: The prevalence rate for eczema in Maltese children was found to be around twenty percent.Eczema accounts for around 3-4% of the consultations in the community. Boys are marginally morelikely to develop eczema before the ages of 2 when compared to girls. Before the end of the first year,60% of children suffering from eczema would have had symptoms. By the age of 14, 75% would haveimproved. 33% of the patient population have an associated family history of atopy, and 30-50% ofchildren with atopic eczema develop asthma or hay fever later in life. Basic treatment involved reducingthe trigger factors and using emollients as the basis of management.Study Limitations: Investigators were not dermatologists but generalists and paediatricians with aninterest in dermatology. Future reviews of atopic eczema would need more dermatology input.Conclusion: Guidance to parents and training to professionals may help to reduce the physical andemotional morbidity for the both child and parents. Recommendations include the restriction of use ofsteroids and antibiotics, the use of non sedation anti histamines, and when needed, referral to thedermatology specialist.
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