Overview
Infected eczema, also known as eczema complicated by secondary bacterial infection, involves skin lesions typically characterized by eczema that have become colonized or infected by pathogens such as Staphylococcus aureus or Streptococcus pyogenes, exacerbating symptoms and potentially leading to complications if untreated 1.Diagnosis
Clinical Presentation: Presence of typical eczema features (erythema, scaling, crusting) with additional signs of infection (pustules, weeping, increased pain, warmth) 1.
Microbiological Testing: Cultures from skin swabs or lesions to identify pathogens and guide antibiotic therapy 1.
Histopathology: Not routinely required but may show neutrophilic infiltration indicative of infection 1.Management
Antibiotics: First-line treatment often includes topical antibiotics such as mupirocin for localized infections; systemic antibiotics (e.g., dicloxacillin, flucloxacillin) for more extensive or severe cases 1.
Wound Care: Regular cleansing with antiseptic solutions (e.g., chlorhexidine) and maintaining skin barrier integrity with emollients 1.
Eczema Control: Continue or initiate topical corticosteroids and calcineurin inhibitors to manage underlying eczema 1.
Follow-Up: Regular reassessment to monitor response to treatment and adjust as necessary 1.Special Populations
Pediatrics: Similar management principles apply, but careful consideration of topical versus systemic antibiotics based on severity and systemic absorption risks 1.
Elderly: Increased susceptibility to complications; close monitoring for signs of systemic infection and adherence to prescribed treatments 1.Key Recommendations
Utilize telemedicine services for remote diagnosis and management of suspected infected eczema, especially in underserved areas, to ensure timely intervention (Evidence: Expert opinion) 1.
Perform microbiological testing (cultures) to guide targeted antibiotic therapy in cases of suspected infection (Evidence: Moderate) 1.
Integrate wound care practices including antiseptic cleansing and emollient use alongside antibiotic treatment to manage both infection and eczema (Evidence: Moderate) 1.References
1 Biscak TM, Eley R, Manoharan S, Sinnott M, Soyer HP. Audit of a state-wide store and forward teledermatology service in Australia. Journal of telemedicine and telecare 2013. link