recommend me a skin specialist for my dd's eczema

[sunglasses]

My dd has what our gp has told us is eczema. She got small patches in skin creases on arms and legs around 6 months ago. My elder daughter had the same and we assumed it was a reaction to suncream. my elder dd's went with hydrocortisone cream after around 3-4 days but my younger dd has just got steadily worse. she has had pimply skin rashes on her trunk and back, red inflamed skin around her eyes and ears, her hairline and we are constantly having to use hydrocortisone to keep it under control. we have tried various creams most of which made it worse and finally thought we had a breakthrough with a week of stronger steroid cream and regular use of epaderm. However she recently had cellulitis which is being treated with two types of antibiotics and a lot of the patches are coming back again!
The doctor refuses to refer us to anyone else so please can someone recommend someone in the London area we can take her to. This only started when she was 2.5 and we are not winning the battle. I am not convinced it is simply eczema and I want a second opinion.

I think you are entitled to ask to be referred to a specialist. Try another GP at your practice and calmly explain that it is absolutely not a critisism of what advice/help they have given you but you are very worried that they could be missing something and you would like the reassurance.

It can be eczema...it can be just as you dscribe. I'm presuming you have bath stuff too...soak in something like oilatum and then smother all over with something such as diprobase every morning and evening once patted dry.. Not sure of your dc ages, but the little ones I look after who have bad eczema love having the moisturiser on after their bath and we make a game of it...making it like a massage with silly noises as we put it on..
Good luck..it can be very distressing..

If it is very itchy, try using a anti histamine suitable for the age and if they must scratch, encourage them to use the flat of their hand and not their nails. x

it sounds like a psoriasis or seborrheic eczema. The other possibility is that the cellulitis which is normally caused by a staph aureus infection ,could be giving her a condition called scalded skin syndrome. Do the red patches look like burns.

Her skin is actually not too bad at the moment but thats because we are using steroid cream on any patches we see before it gets too bad. We are religious with the epaderm which is an emollient moisturiser which we can also use in the bath. We have given her anti-histamine when the itching is bad but I dont notice any reduction in scratching. I think I am just worried that we are relying too heavily on the steroid cream. Whenever we stop using it despite using the epaderm it just gradually creeps back again. She is nearly 3 now and I would like to get to the bottom of what is triggering this. The doctor just refuses to refer us for allergy tests as she says we havent tried all the creams etc. The epaderm is by far the best we have had and she doesnt mind it being put on or react in any way to the ingredients unlike plenty of others- including oilatum in the bath etc. Not heard of scalded skin syndrome? I dont think she has developed anything new after having the cellulitis, just all the old patches crept back.
I dont want to be on a long waiting list for a referral by the gp so am quite willing to go private. Any Recommendations?

Dr Harper at GOS is an excellent dermatology consultant-go onto the GOS website and I am sure there are links to the private patients wing and you can phone and see if he does private work-I also know the team at the Royal Free but on an adult rather than paediatric basis so not sure who the children see there.
HTH

Thanks for that. Will check that out. Have you had experience of this problem yourself?

when you use steroids for a longer period of time(over 2 weeks) you often get a rebound reaction which i what your dd seems to be getting ,once you stop the steroid. There is a place for steroids during flare ups but the more emollients and steroid-sparing creams you can use, the better.

Epaderm is a good emollient. It is a matter finding one that suits her. E45 stings some people....emulsifying ointment is also good to use as a soap substitute in the bath (although a little messy).
Does she have asthma or hayfever at other times or is it in your family.

Aveeno oatmeal cream will help with itching and may stop the need for antihistamines.Is she on piriton as her anti histamine.

Also Alpha keri lotion and bath oil are good and emulsiderm.

I used to work in dermatology...do you have any photos of her red patches,just in case i can help.

Thanks alypaly. Keep hearing about this rebound eczema although no doctor has ever mentioned it. I think this is exactly why the problem escalated from a few patches to this all over skin rash. Her skin is actually pretty clear at the moment but this is because I am using the steroid cream on the worst patches even after they have subsided and being religious with the epaderm. All the emolient creams in the past have actually made her more itchy which also didnt help. Aveeno worked for us at first but very quickly that made her itch too. She doesnt have asthma or hayfever but I do. I have also suffered from extreme itching skin although never had eczema as such but contact dermatitis with some metals. There are a lot of so called dry skin creams etc including E45 which i cant use and also a lot of bath stuff like oilatum etc. The best moisturiser for me at the moment is organic surge- no itching at all with that. Perhaps she has sensitive skin like me.
I havent got pics of her skin bit when it was really bad it was slightly raised red pimply patches on her back and trunk and sore red patches around eyes and mouth, chin and lower cheeks.
I think we may be on a winning curve at the moment but I wanted to get a second medical opinion to see if we should be doing anything else to stop it returning.

Only know Prof Harper professionally so no direct patient experience but he has an excellent reputation
Good Luck

if you suffer from asthma or hayfever ,then there is a high chance of your children inheriting the gene as asthma eczema and hayfevee are linked genetically. Also you may find that when the hayfever is bad asthma is better and vice versa.If dad has it too then it increases the chances of her having theses problems.

I wouldnt use the steroid once the redness has gone as you will make the rebound reaction more pronounced and also it will cause thinning of the skin and telengectasia as she gets older.

dont know where you live,but when i worked in dermatology...DR T P Kingston in Manchester /stockport was brilliant.