Q: My niece is two and a half years old. She has skin rashes on her hands and legs around the joints. She has been having this problem from birth. Earlier the rashes were also present on her face but these have now disappeared. We were advised that the rest of them will also disappear as she grows up. But these persist. The rashes itch a lot. The doctors we have shown says it is eczema. They have precribed some creams which give temporary relief only. We are very worried. Please advise.

A:Your niece probably has Atopic or Infantile eczema which is an inherited condition in allergic families. Initially the eczema is extensive, but gradually limits itself to the creases around joints, such as elbow and backof the knee. The most important principle of treatment is to prevent itching and sweating and avoid using irritant soaps on the body. Periodically, when it flares up, one has to use a mild steroid creme such as Flutivate (GLAXO), but otherwise the skin should be frequently moistened with EMODERM (GLAXO). Letting the baby play for an extended period in lukewarm water two or three times a day, at all times is an effective strategy. One could also use long acting anti- itching agents such as Cetzine or Altiva (1/2 tsf. twice a day. No woollens or synthetics should ever come in contact with the skin, even in winter. Only unstarched soft cottons areallowed next to the skin. Occasionally we have to use antibacterial local cremes, such as Neosporin to control infection, associated with itching. The disease does get milder, as the child grows older. I hope this helps your neice.