Clinical and Communication Skills Take a history that allows determination of risk factors for eczema, associated conditions, assessment of severity, current treatment including quantity and duration; assess possible 'steroid phobia' Examine the skin and assess the extent and degree of involvement of the eczema; examine for clinical evidence of scabies, eczema herpeticum and molluscum contagiosum; establish if there is secondary bacterial infection and know features of impetigo and furunculosis Describe the clinical features observed using dermatological terminology Role and indications for bacterial and viral swabs Management of mild to moderate eczema including use of emollients; appropriate use of topical steroid ladder; give family a clear explanation of how to apply topical preparations and appropriate quantities, and demonstrate where necessary Understand the management of severe and refractory eczema e.g. the concept of 'wet wraps' and 'weekend treatment'; topical immunomodulators such as pimecrolimus; phototherapy; systemic agents (anti-inflammatory corticosteroids, azathioprine, methotrexate, ciclosporin) Explain how to recognise rashes in children and important skin infection and how to manage this within a household Assess the impact of this chronic disease on the patient and family/whānau; establish a short term and then a realistic longer term goals of management with the patient and the family/whānau
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