Diseases of the skin. Management of eczema. II.

Judicious use of topical corticosteroids for their non-specific anti-inflammatory effect is central to the management of eczema, whatever its cause. Their effect is suppressive and if the cause of the eczema continues to operate over an indefinite period, topical therapy will have to be prolonged, bringing in its wake the now well-known hazards of such treatment. The prescriber must choose his steroid and also the appropriate vehicle (ointment, cream, gel, or lotion). He should be guided by the intensity of the inflammation, its likely duration, and its site in choosing the steroid-and by the physical nature of the eczematous surface in selecting the vehicle. These points were discussed in detail by Dr. J. H. Hunter in the second article in this series (British Medical Journal, 17 November, p. 411)