Eczema, acute, moist or weeping

L20.0/L20.8-9


L20.0/L20.8-9

DESCRIPTION

A form of eczema with small or large vesicles, associated with oozing and eventual crusting and scaling. Yellow pustules which crust indicate sepsis.

GENERAL MEASURES

  • Sodium chloride 0.9% dressings, applied daily or twice daily.
  • Avoid use of soap on affected areas.

MEDICINE TREATMENT

Topical steroids, e.g.:

  • Hydrocortisone 1%, topical, applied 12 hourly, until improved.
    • Topical steroids should be applied to both moist and dry inflamed areas.

Antibiotic treatment if secondary infection is present:

Children ≤ 7 years of age

OR

Children > 7 years of age and adults

  • Cefalexin, oral, 500 mg 6 hourly for 5 days.

OR

  • Flucloxacillin, oral, 500 mg 6 hourly for 5 days.

Severe penicillin allergy: Z88.0

Children

Adults

  • Macrolide, e.g.:
    • Azithromycin, oral, 500 mg daily for 3 days.

For itching

Children

Adults

  • Chlorphenamine, oral, 4 mg, at night.

LoEIII

Note: Chlorphenamine is sedating.


CAUTION
Do not give an antihistamine to children < 2 years of age.


If itch not controlled or more severe daytime itch, switch to:

Children: 2–6 years of age

  • Cetirizine, oral, 5 mg once daily. See paediatric dosing tool.

Children > 6 years of age and adults

  • Cetirizine, oral, 10 mg once daily.

LoEIII

For itching in children < 2 years of age:

  • Calamine lotion, applied on the skin

REFERRAL

  • No improvement after a week.
  • Severe acute moist or weeping eczema.