Eczema: “Skin Asthma”
Managing parent expectations is half of pediatric emergency medicine. When parents bring in kids with worsened eczema (either as a chief complaint or a side complaint), they are often frustrated that they used the prescribed cream, things got better, but now the rash is back. I like to explain that eczema is like “asthma of the skin,” and to expect “attacks” or “flares” just like asthmatics get, depending on environmental pollen counts, dry air, etc. When an asthmatic has a flare, they use their albuterol inhaler, and when someone with eczema has worsened rash, they ramp up their dry skin regimen and use steroid creams. Lately I’ve also been comparing hand-foot-mouth to “a virus in the chickenpox family” with similarities that it has to get better on its own, antibiotics don’t help, and it takes 7-10 days for the lesions to heal up.