Further Product Information

Written by Dr Stephen Kownacki MB BS MRCGP, General Practitioner, Wellingborough, Northamptonshire, Hospital Practitioner in Dermatology, Northampton General Hospital Trust, Chairman, Primary Care Dermatology Society.

CONTENTS

Summary
Introduction
Management not just treatment
Organisation
Equipment
Assessment
Impact on quality of life
Lifestyle modification
Clinical management
Constraints
Clinical audit
Support
Conclusion
Key points

SUMMARY

Atopic eczema has a profound impact on the health and quality of life of individual patients and their families, with disease severity directly influencing the extent of this impairment. The condition also imposes a major burden on healthcare resource consumption and its associated costs. For example, in the primary-care setting alone we can expect one patient in every 20 that we see to have atopic eczema. An appreciation and understanding of the burden of this major condition is essential if we are to motivate ourselves and our healthcare colleagues to find ways to manage it effectively. By examining how we currently deal with the problem of atopic eczema, we can identify areas where we can improve practice and will allow us to formulate effective management plans to ensure better care for our patients in the future. The involvement of the entire primary-care team and the adoption of an education and awareness campaign for all practice staff will also help us manage the condition more effectively. As with any chronic condition, people living with eczema and their families are likely to benefit from an improved understanding of their condition. Support is widely available from a variety of different sources to assist in this. Effective diagnosis, of course, lies at the heart of successful clinical management, and whilst this is relatively straightforward for atopic eczema, there are a number of complicating factors including disease severity, which can ultimately affect treatment choice. Indeed, given that more severe disease presentation is associated with a more profound impact upon psychosocial factors, greater benefits for both the patient and their family can be attained when such patients are treated effectively. Lifestyle changes can help to minimise disease flares and improve the overall control of the condition and as we have seen in the preceding sections, a variety of pharmacological approaches are available to manage atopic eczema of varying severities. The recent introduction of the calcineurin inhibitors may lead to a paradigm shift in the way we manage acute exacerbations of atopic eczema, towards more effective prophylaxis in the longer-term.

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