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1、Issue date: December 2007NICE clinical guideline 57Developed by the National Collaborating Centre for Womens and Childrens HealthAtopic eczema in childrenManagement of atopic eczema in children from birth up to the age of 12yearsNICE clinical guideline 57Management of atopic eczema in children from
2、birth up to the age of 12yearsOrdering informationYou can download the following documents from www.nice.org.uk/CG057 The NICE guideline (this document) all the recommendations. A quick reference guide a summary of the recommendations for healthcare professionals. Understanding NICE guidance informa
3、tion for patients and carers. The full guideline all the recommendations, details of how they were developed, and reviews of the evidence they were based on.For printed copies of the quick reference guide or Understanding NICE guidance, phone the NHS Response Line on 0870 1555 455 and quote: N1427 (
4、quick reference guide) N1428 (Understanding NICE guidance). NICE clinical guidelines are recommendations about the treatment and care of people with specific diseases and conditions in the NHS in England and WalesThis guidance represents the view of the Institute, which was arrived at after careful
5、consideration of the evidence available. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. The guidance does not, however, override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances
6、 of the individual patient, in consultation with the patient and/or guardian or carer and informed by the summary of product characteristics of any drugs they are considering.National Institute for Health and Clinical ExcellenceMidCity Place71 High HolbornLondon WC1V 6NAwww.nice.org.uk National Inst
7、itute for Health and Clinical Excellence, 2007. All rights reserved. This material may be freely reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the express written permission of the Institute.
8、ContentsIntroduction4Child-centred care5Key priorities for implementation61Guidance111.1Diagnosis111.2Assessment of severity, psychological and psychosocial wellbeing and quality of life131.3Epidemiology141.4Identification and management of trigger factors151.5Treatment171.6Education and adherence t
9、o therapy271.7Indications for referral282Notes on the scope of the guidance303Implementation in the NHS314Research recommendations324.1Infant feeding324.2Prevention of flares324.3Early intervention334.4Adverse effects of topical corticosteroids334.5Education and adherence to therapy345Other versions
10、 of this guideline345.1Full guideline345.2Quick reference guide355.3Understanding NICE guidance356Related NICE guidance357Updating the guideline35Appendix A: The Guideline Development Group36Appendix B: The Guideline Review Panel38Appendix C: The algorithm39IntroductionAtopic eczema (atopic dermatit
11、is) is a chronic inflammatory itchy skin condition that develops in early childhood in the majority of cases. It is typically an episodic disease of exacerbation (flares, which may occur as frequently as two or three per month) and remissions. In some cases it may be continuous. Atopic eczema often
12、has a genetic component that leads to the breakdown of the skin barrier. This makes the skin susceptible to trigger factors, including irritants and allergens, which can make the eczema worse. Many cases of atopic eczema clear or improve during childhood, whereas others persist into adulthood. Some
13、children who have atopic eczema will go on to develop asthma and/or allergic rhinitis; this sequence of events is sometimes referred to as the atopic march. Although atopic eczema is not always recognised by healthcare professionals as being a serious medical condition, it can have a significant neg
14、ative impact on quality of life for children and their parents and carers.This clinical guideline concerns the management of atopic eczema in children from birth up to the age of 12 years. It has been developed with the aim of providing guidance on: diagnosis and assessment of the impact of the cond
15、ition management during and between flares information and education for children and their parents or carers about the condition.Child-centred careThis guideline offers best practice advice on the care of children up to the age of 12 years with atopic eczema.Treatment and care should take into account childrens needs and preferences, as well as those of their parents or carers. Children with atopic eczema should have the opportunity to be involved in decisions about their care and treatment in partnership with their healthcare professionals. It i
