Atopic Eczema in Children at School Start

Diagnosis and Clinical Features

The British Medical Journal recommends that atopic eczema diagnosis is made on clinical grounds based on specific criteria, including itchy skin condition with report of scratching or rubbing in the child, and at least three of the following: history of itchiness in skin creases, history of asthma or hay fever, general dry skin, visible flexural eczema, and onset in the first two years of life 1, 2, 3
The diagnosis of atopic eczema is supported by the presence of atopy in first-degree relatives, which strongly suggests eczema diagnosis 1, 4
Atopic eczema is a chronic, relapsing inflammatory skin condition that affects children with significant morbidity, and deterioration in previously stable eczema commonly occurs with environmental changes 1, 2

Exposure to irritants such as soaps, detergents, and hand sanitizers in school settings can remove natural lipid from the skin surface, exacerbating atopic eczema symptoms 2, 3
Temperature extremes between air-conditioned classrooms and outdoor play areas should be avoided to prevent exacerbation of atopic eczema symptoms 2
Stress and sleep disturbance associated with school routines can exacerbate atopic eczema symptoms 1, 2

Impetigo is a highly contagious bacterial infection of the superficial epidermis that predominantly affects children and is one of the most common skin and soft tissue infections in children worldwide, presenting as discrete purulent lesions caused by β-hemolytic Streptococcus and/or S. aureus 5
Hand, foot, and mouth disease typically presents within 2-4 days of illness after an incubation period of approximately 5-10 days after exposure, with symptoms aligning perfectly with school exposure and symptom onset 6