Eczema or atopic dermatitis (AD) is the first visible sign that indicates a much bigger and more complex problem within the body. The first presentation of symptoms is typically in individuals less than six months of age. Concerned parents bring their child to the pediatrician where a course of topical corticosteroids is prescribed, according to current AD treatment guidelines (Weston, & Howe, 2019). Long term use of corticosteroids has proven to be detrimental to the patient’s health, especially pediatric patients, in many ways such as gynecomastia, hypertrichosis, staphylococcal infections, skin atrophy, and worsening of skin diseases, just to name a few (Coondoo, Phiske, Verma, & Lahiri, (2014). Applying topical steroids to an eczematic rash is the equivalent of applying a tourniquet to a stab wound, it temporarily alleviates the issue but does not fix or address the underlying cause or problem.

Eczema has been linked to the existence of positive IgE-mediated food allergies and food sensitivities (Foong, Roberts, Fox, & du Toit, 2016). In fact, the patients with the earlier onset of eczema symptoms have the highest levels of IgE and the most severe symptoms, skin erythema, edema, oozing and crusting, skin excoriation, lichenification, and dryness (European Task Force on Atopic Dermatitis, 1993). Poorly treated, undertreated, or untreated eczema leads to a lifetime of comorbid allergic issues signified as the atopic march which includes asthma, that carries its own list of potentially life-threatening complications. Eczema is perceived to be a patient only problem but the current financial burden of over $5 billion indicates that is a lie.

For all of these reasons, the approach and plan of treatment for eczematic patients needs to be revised. Allergy testing should be offered and utilized to develop a short term, three-month, hypoallergenic diet with patient symptoms assessed before and after. Details and recommendations are as follows in this paper.

Date of publication

Spring 5-2-2020

Document Type

MSN Capstone Project



Persistent identifier



Masters of Science in Nursing