Dermatitis Case

Dermatitis Case
AR is a 7-month-old boy brought to your office by his mother, concerned about her son’s intermittent, pruritic rashes. She reports that the rashes started when AR was about four months old and was initially concentrated on his cheeks and around his mouth. Since that time, the rashes seem to come and now intermittently affect his trunk and extremities. He frequently scratches the affected areas. His mother notes that the areas covered by his diaper are not involved. She has treated the condition with various “baby lotions” and is uncertain whether they help. She notes that she and her husband are not affected by any itchy rashes, and she doesn’t know of any close contacts who are experiencing this problem either. He is otherwise healthy and meeting developmental milestones. AR’s father has a history of asthma.

On examination, AR is attentive and appropriately interactive. Vital signs are within normal limits. Cutaneous examination reveals symmetric, ill-defined, brightly erythematous, scaling, pink patches on his cheeks and similar, although milder, patches on his trunk and extremities.

You diagnosis AR with atopic dermatitis

What do you think is an appropriate first-line treatment for AR?
What counseling points do you give his mother?
When would you want to follow up with AR?

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