From the Guidelines
The treatment for whole body contact dermatitis in an 8-year-old child involves a multi-step approach, starting with the identification and removal of the triggering allergen or irritant from the child's environment, as emphasized by the British Association of Dermatologists' guidelines for the management of contact dermatitis 2017 1. The first step in managing whole body contact dermatitis is to identify and avoid the allergen or irritant causing the reaction. This can be achieved by assessing the child's environment and removing any potential sources of exposure.
- Identify and remove the triggering allergen or irritant from the child's environment.
- For immediate relief, give lukewarm baths with colloidal oatmeal for 10-15 minutes daily, followed by applying a fragrance-free moisturizer like CeraVe or Vanicream while the skin is still damp.
- For medication, start with a low-potency topical corticosteroid such as hydrocortisone 1% cream applied twice daily to affected areas for up to 7 days, as suggested by guidelines for the management of contact dermatitis: an update 1.
- For more severe cases, a medium-potency steroid like triamcinolone 0.1% may be needed, but avoid using it on the face, genitals, or skin folds.
- Oral antihistamines like cetirizine (5-10mg once daily) or diphenhydramine (12.5-25mg every 6 hours, not exceeding 75mg daily) can help manage itching, as discussed in guidelines of care for the management of atopic dermatitis: section 4 1.
- For extensive or severe dermatitis that doesn't respond to these measures, consult a pediatrician or dermatologist, as they may prescribe a short course of oral steroids like prednisolone (0.5-1mg/kg/day for 5-7 days). It is essential to keep the child's fingernails short to prevent skin damage from scratching and dress them in loose cotton clothing to minimize irritation, as highlighted in clinical practice guideline: acute otitis externa 1.
From the FDA Drug Label
If irritation develops, topical corticosteroids should be discontinued and appropriate therapy instituted. In the presence of dermatological infections, the use of an appropriate antifungal or antibacterial agent should be instituted. If a favorable response does not occur promptly, the corticosteroid should be discontinued until the infection has been adequately controlled
For an 8-year-old child with whole body contact dermatitis, the treatment should be approached with caution.
- Topical corticosteroids like hydrocortisone butyrate may be used, but it's essential to monitor for signs of systemic toxicity and HPA-axis suppression.
- Appropriate therapy should be instituted if irritation develops, and antifungal or antibacterial agents should be used if a dermatological infection is present.
- It's crucial to follow the physician's instructions and report any signs of local adverse reactions.
- Given the potential risks, it's recommended to use the lowest effective dose and for the shortest duration necessary 2.
From the Research
Treatment for Whole Body Contact Dermatitis in an 8-Year-Old Child
The treatment for whole body contact dermatitis in an 8-year-old child involves several steps, including:
- Avoidance of the causative substance, if known 3, 4, 5
- Use of topical corticosteroids, such as triamcinolone 0.1% or clobetasol 0.05%, for localized acute allergic contact dermatitis lesions 3
- Systemic steroid therapy for extensive areas of skin involvement (greater than 20 percent) 3
- Patch testing to identify the specific allergen, if the diagnosis or specific allergen remains unknown 3, 5
Medical Therapies
Medical therapies for severe contact dermatitis in pediatric patients include:
- Topical corticosteroids 5
- Topical immunomodulators 5
- Oral corticosteroids or immunomodulators for severe cases 5
Important Considerations
It is essential to note that: