sleep deprived mum

[Anita1975]

I am new to this site and welcome any parents, carers or specialists to chat to and discuss the issues surrounding my little boy's condition. We have recently been referred to a dermatologist after several visits to the gp asking for a referral. We are currently eliminating dairy products from his diet, using ointments as opposed to creams and surcare for washing. I am at my wits end and am having some time off work as i havent slept properly in months and it was beginning to take its toll on my health PLease help!

[Marcie Mom]

Hi Anita,

Is your little boy older than 6 months? You can bring him for an allergy test and that will help identify some triggers. Moisturizing is a must and it'd be good to see a doctor who specializes in children and dermatology/allergy/immunology. Some info on allergy tests posted on my blog:

The type of allergy test recommended is based on the allergy symptom of the patient. As eczema is a mixed IgE/non-IgE driven disease process, tests for IgE like SPT and blood tests may be useful if positive, as targeted elimination may be attempted. If the tests are negative, empiric elimination of 2-3 weeks duration may still be considered if there appears to be a consistent food trigger. Prolonged avoidance however is not necessary and may result in malnutrition.

A skin prick test (SPT) is probably commonest and simplest allergy test performed in outpatient clinics. Essentially it is a scratch test with either a needle or plastic device, thus introducing a tiny amount of allergen protein under the skin surface. The test is completed within 15 minutes and measurement taken. A positive reaction appears as a small hive-like wheal and surrounding redness. It is good for identification of IgE mediated allergic reactions, and also for trending allergy sensitisation over time. Antihistamines would need to be ceased for 5-7 days, and there must be an area of clear skin (preferably the back in young children) for the test to be done. This is my preferred allergy test as there is minimal pain (especially with plastic devices), and results immediate. SPT also correlate better with allergic reactions if properly performed, as it takes into account the blocking antibody responses when the body is “outgrowing” an allergy.

Allergen specific IgE test can also be easily performed for IgE mediated reactions. This is sometimes preferable if the patient has severe eczema and unable to tolerate cessation of antihistamines, or has minimal normal skin to perform the SPT. Blood tests are generally more expensive, as each allergen protein tested cost around $30. Results are usually known within a week.

Patch tests are designed to test for delayed allergic reactions, rather than acute IgE reactions as the above 2 tests. Patch tests involved placing small area of allergen protein coated on wells or filter paper, and leaving them as a skin patch for 48 to 72 hours. A reading is then performed to look for delayed hypersensitivity reactions and the skin reaction graded. As there are several confounding factors for a successful test, patch tests are currently not recommended for clinical use but confined to research studies.

Hope above info helps, and all the best to managing the eczema.
Mei