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Discoid Eczema (Nummular Dermatitis) that is not responding

     
Note: Some names have been changed for privacy reasons

Question about 2 year old with discoid ezcema that has not responded well

Our 2 year old daughter has discoid ezcema that has not responded well despite mutliple short courses of prednisolone and antibiotics, constant wet dressings, topical corticosteroids and a rigid moisturising routine. Her dermatologist feels the next step is methotrexate, which we are trying to avoid. She picks at her lesions constantly, wakes up with blood all over the sheets and is becoming scarred and disfigured. We heard your cream helped someone, and we have tried EVERYTHING - homeopathy, chinese medicine, diet restriction (ongoing) as well as all the conventional stuff. We are praying that your balm will work miracles! Thanks.

Hi,
Apply the Hypoallergenic Balm as often as possible, if no result within 1 week  let me know
and I will send you some of  our Psorexederm ointment which is not on the
Web site since it requires our selection and recommendation.
You would then apply the 2 alternately.
Try the balm first to see how the eczema responds and let me know how you
are going.
I will be away from Jan 14-21 so any email in that time I will respond too
after that.
Hopefully you will get a good response. Do not discontinue any cortisone she
is currently using as this will cause a cortisone withdrawal flare up about
2-3 days after stopping the cortisone.
I tend to be conservative so give it a 50/50 chance of helping. Hopefully it
will and certainly let me know how things go.
Kind Regards,
David Hosking 3/01/08
Hi David, Thanks for your email, I really appreciate your advice. With regards to her cortisone ointment (Elocon), I am finding that she has become 'resistant' to its effectiveness. We have not been able to have the recommended 'rest' periods ie: stop using the creams for a few days before starting again, as it is never under control. And even when we are using it continuously, in addition to wet dressings/ moisturising etc, the eczema is still pretty severe. Should I be trying another cortisone?  (we have used Celestone in the past which was not effective). I was hoping to use your cream instead of Elocon as I feel it is not benefitting her and yet she is being exposed to the risks of ongoing use. Another problem I've had with some of the creams I've tried is that many of them really hurt her. eg) Dermaveen Eczema cream which I tried yesterday. She seems to be okay with QV cream and plain sorbolene and Dermeeze. Is it likely that your product will cause her pain when applied? Thanks very much,

Hi,

None of our products cause pain when applied, I try to follow the axiom that the treatment should not be worse than the disease. I would continue to use the Elocon under the Balm to avoid a flare-up occurring due to sudden cortisone withdrawal which occurs about 2-4 days after stopping a cortisone cream. Apply the Elocon as before and use our balm over the top about 3-4 times a day. When improvement occurs ,halve the elocon dose for the next week and continue with the balm as above. Then all being well, stop the elocon on the third week. This seems to work well for most people.

You may get flare-ups from time to time and need to add the elocon occasionally. This usually happens after a cold or something stimulating the immune system. If so just repeat the procedure as above to get the eczema under control again. Children do grow out of it so I suspect it is related to immune responses. Sometimes adding claratyne or zyrtec syrup may help but try one thing at a time so you can see what is working,

Kind Regards, David Hosking 7/01/08

QUESTION: my daughter's eczema - I think it may be discoid eczema. I don't like to be dependent upon cortizone

I've learnt a bit about discoid eczema and I realise it may take time to clear up. The last time my daughter had the problem, it was over 5 years ago but also on her feet. It was incorrectly dealt with from the start and took over 9 months to clear. It seems very similar to the last time she had it and the eczema gets infected with golden staph, but not the antibiotic resistant strain.

As I was more aware this time of what the problem was, I have had the advantage of knowing a little more about treatment from the start, although I thought she just had tinea for several weeks before I finally realised it had developed into eczema. My problem is that I seem to be able to keep the eczema under control to an extent, but it's still a bit of a mystery to me, and I really don't like using cortizone cream regularly which we presently doing. We're using Eulaphrat ? cortizone once a day, on top of 50% sorbolene, under a damp dressing for 20 minutes. I just keep putting sorbolene on as many times as I can during the day as well as an eczema cream - Medihoney. So far we've gone through 2 cycles of 7 days with cortizone, in between those 2 cycles, 4 days without cortizone for the first 'round' and 5 days off last week. Then after the 5th day off, there was inflammation again, and the next day blisters and today, large blisters. Today has been the 4th day of cortizone. Do you think that the product you are recommending would help?

I'm sorry that I don't know how to send an image, but I can describe it - it's only a relative small area on the tops of two toes (little toe and the next one to it) and a bit on the foot area just above where the toes join. There's another area underneath the third toe and tonight I noticed two large blisters, but they don't appear to be very painful. On the other foot, it's on nearly the same place - on the area just where the little toe joins the next toe but not on the toe itself.

Finally, I was given a tube of antibiotic ointment to put on the area three times a day, but it didn't really seem to do anything to help, especially when there isn't a flare up. Any ideas, and as I asked above, do you think your product could be incorporated so as to stop using the cortizone - and yet keeping the flare ups under control?


ANSWER:

'Discoid dermatitis (nummular eczema) presents as round or oval plaques of dermatitis with clearly demarcated edges. The plaques are prone to secondary bacterial infection. The condition is not uncommon and usually presents in middle to late adult life but may occur in children. The cause is unknown, but dry skin and overheating are important aggravating factors.

If you are able to email me an image of the affected area I may be able to help. Our Psorexederm cream is anti-inflammatory with antibacterial properties and is also excellent at reducing itch.

As the Hypoallergenic face and body balm is more protective than sorbolene, I would replace the sorbolene with the balm. That should immediately stop the blistering which I imagine must be painful. Avoid the medihoney as it can dry out the skin and do the cycles again with the eleuphrat and Hypoallergenic balm only with a damp dressing on top. I think you will be very surprised at the improvement as we have had experience with this before and the last child was eventually completely recovered. I don't promise that, but an improvement well worth the effort should result. Kind Regards, David Hosking 8/8/08

Introducing David's Hypoallergenic Face and Body Balm

We formulated the lavender -free balm (removed the lavender oil) for infants, babys and children with hypersensitivities. The hypoallergenic balm should work precisely the same as our Lavender Balm product, although, of course, it does not come with the lovely smell and color of the Lavender oil.

The hypo allergenic product without lavender oil conforms to the guidelines of Sue Dengate ( see; http://www.fedupwithfoodadditives.info/) who is prominent in helping children with food additive sensitivities. These children also tend to have eczema and so the Hypoallergenic product without lavender was born after requests from a number of customers. Directions for use are exactly the same as for David's Soothing Lavender Face & Body Balm.

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Copyright © - 2002-2008 - Help for Discoid Eczema - David Hosking's Pharmacy (Compounding Chemist)
23A Keilor Road, Essendon, Victoria, Australia
www.hoskingspharmacy.com


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