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Hello, new to this board - so relieved to have found it!

(4 Posts)
greencybermummy Fri 03-Jun-11 09:49:23

My DD (3 this month) is suffering terribly just now, has had eczema since 6mths ish but since the lovely weather at Easter it has ramped up a notch and since then has been pretty much out of control.

Finally have referral to hospital, counting the days til the appointment! Current main issues are scratching particularly at night but not exclusively. She has been on Ab's almost constantly since Easter and also a course of oral steroids (horrid things, made her a sad little girl). Use 1-2 500g pots of Epaderm a week at the moment - everything is clarty!

Think our triggers are pollens and some food stuffs but it's so hard to pin down. How do they do testing at hospital? I'd like to prepare her if possible as she is much better if she knows about what is going to happen at an appointment.

Is is normal to sometimes loose sympathy for your child? I feel so bad in myself especially at night when I am up with her for the nth time and swing from feeling so sorry for her to feeling really frustrated with her, I am wrestling with my feelings and don't know what to do about it.

Sorry for the off load - am glad to join you though.

vanessasmum Fri 03-Jun-11 10:43:30

Hi there! i think it is totally normal to lose patience, esp at night. you have a very needy and therefore demanding child, and it stretches us! My little girl is 5 had has had eczema since 6 month too, and the dermatology nurses have been fabulous at supporting me in keeping it under control. she has has allergy testing: a blood test which was handled very well: taking blood can be traumatic so they has 2 childrens nurses, and a carefully planned set up so that she was distracted very sucessfully. I don't know how seriously they take the idea of food intolerances causing eczema, so ask them about it. tell her how nice the childrens nurses are and that they are going to be kind and might even play with her... although i think our hospital was particularly good, other people might have more negative experience of having blood taken... don't know how you would find out for your local hosp....

Things will improve!

pinkorkid Fri 03-Jun-11 11:36:23

Hi greencybermummy, I'm also relatively new to this board but have a dd aged 10 with pretty severe eczema and allergies and have some experience of testing and hospital visits which I can tell you a bit about. But first wanted to say feeling frustrated with your dd waking you up repeatedly at night is perfectly normal - sleep deprivation is a well known torture device after all, so don't feel too guilty.

From our experience there are 2 ways of testing for allergies: skin prick test or blood test.
With the skin prick test potential allergens are introduced via a prick to the skin and the diameter of the resulting red weal is measured to give the scale of the reaction. Results are measurable pretty much instantly but there is sometimes an issue with using this test on active eczema if the skin is already red and inflamed it can be hard to judge the results.

The alternative is to draw a sample of blood which can then be tested in the lab to see what level of IGE is produced in reaction to specific allergens. Reactions are measured on a scale of 1 to 6 with 1 being a mild reaction and 6 an extremenly high reaction. Anything over 4 is potentially in the anaphylactic range. Results usually take a couple of weeks.

As for the blood test itself they will numb the skin first - could be just with a spray to temporarily freeze it but you would still feel the prick or more likely a cream which they leave on under a plaster for up to an hour which really does numb it before the needle goes in.

Have you used steroid creams as well as oral steroids in the past? I would imagine they will discuss how your dd's skin has reacted to the creams you have used in the past, how you have applied them, how long they have been used for, how compliant your dd is with the treatment. They should advise you on the best way to apply them - there should be a gap of about half an hour between applying steroids and emollients so that the steroid is not diluted by the emollient. In some cases they would recommend emollient first so the skin is more supple and will absorb steroid better but in some cases where the emollient used is one of the more effective and longer lasting barrier creams like epaderm they would probably recommend steroid first.

Other treatment options they may suggest or you can ask about are using dry or wet wraps where emollients and/or steroids are used under occlusion ie with stretchy bandage type leggings and vests worn on top to improve absorbtion. Wet wraps have the first layer soaked in warm water wrung out tight and then dry layer on top but only used when no infection is present as would make infection worse. Also would monitor steroid use very carefully as much more absorbed into the skin this way.

They will be likely to take a skin swab and nasal swab to check levels of staph aureous on skin - most likely cause of most skin infections. Most eczema sufferers carry this to some degree on their skin all the time and when it builds up to a high enough level will cause infection but may still cause problems at a sub-clinical level.

If you have used steroid creams a lot and not had a good response, they may suggest using a second line treatment such as tacrolimus or picrolimus. These are immunomodulators which dampen down the excessive immune response. They are particularly useful if your child has bad eczema on their face where steroid use would be problematic. Disadvantages are makes you more sensitive to sun so have to extra cautious with sunscreens/covering up and also may make you more prone to infections because dampens down the ability to fight off the infections as well as the immune response.

Hope that helps. Also you might find that using eczema nightware with hands enclosed will help control scratching at night.
Another thing to consider is that your dd should be eligible for DLA as her care needs during the day and at night are considerably greater than that of her

greencybermummy Fri 03-Jun-11 13:26:31

Thank you so much for the quick informative replies, much appreciated. Have been making a little thumb hole this morning in some new nightwear, I feel like I am keeping a certain company in business just now with the amount of orders and things we have tried!!

Obviously we will battle on but bloomin heck it's hard work at times isn't it? My DD knows that what she's got is eczema and argues with the children at nursery who try and convince her she's got chicken pox!

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