The William Lovell Putnam Mathematical Competition. Problems by Andrew M. Gleason

By Andrew M. Gleason

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Where emollients (excluding bath emollients) and other topical products are used at the same time of day to treat atopic eczema in children, the different products should ideally be applied one at a time with several minutes between applications where practical. The preferences of the child and parents or carers should determine which product should be applied first. Topical corticosteroids Healthcare professionals should discuss the benefits and harms of treatment with topical cortico­ steroids with children with atopic eczema and their parents or carers, emphasising that the benefits outweigh possible harms when they are applied correctly.

16 Summary of recommendations and treatment algorithm Healthcare professionals should offer a 7–14 day trial of an age-appropriate sedating antihista­ mine to children aged 6 months or over during an acute flare of atopic eczema if sleep disturbance has a significant impact on the child or parents or carers. This treatment can be repeated during subsequent flares if successful. Treatment for infections associated with atopic eczema Children with atopic eczema and their parents or carers should be offered information on how to recognise the symptoms and signs of bacterial infection with staphylococcus and/or streptococ­ cus (weeping, pustules, crusts, atopic eczema failing to respond to therapy, rapidly worsening atopic eczema, fever and malaise).

1% ointment for treating children with atopic eczema? 1% ointment is not licensed for use in children under 16 years. 03% preparation of topical tacrolimus. High-quality RCTs and safety studies are required to answer this question. What are the optimal treatment durations when using topical pimecrolimus and tacrolimus in the treatment of children with atopic eczema? Why this is important The topical calcineurin inhibitor formulations are new and relatively expensive with optimal treatment duration strategies not yet established.

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