Pediatric Eczema Follow-Up Case: Improving Chronic Atopic Dermatitis in a 5-Year-Old Patient
At Village Dermatology, we frequently care for children with eczema (atopic dermatitis), a chronic but manageable skin condition that can significantly affect quality of life for both patients and their families. This case highlights the importance of consistent skin care, medication optimization, and long-term management for pediatric eczema patients in Katy and Houston, Texas.
Patient Presentation
A 5-year-old female returned to our clinic for a follow-up evaluation of eczema affecting the right hand and trunk. She was initially seen in August 2024 and started on triamcinolone acetonide 0.1% topical cream, applied twice daily during flares with a maximum of 14 days per month.
At this visit, her father reported overall improvement with treatment; however, the child continued to experience intermittent flares and nighttime itching, prompting further evaluation and adjustment of her treatment plan.
Clinical Examination
A focused skin examination was performed, including the chest, bilateral forearms, and lower legs. Dermoscopic evaluation revealed coin-shaped (nummular) eczematous patches on the right hand and trunk. The patient appeared well-developed, well-nourished, and in no acute distress.
Assessment
Atopic dermatitis (eczema), chronic with flares
Coin-like eczematous patches on the right hand and trunk
Treatment Plan & Counseling
Given the persistent flares, the treatment plan was optimized to improve symptom control while minimizing long-term steroid exposure:
Continue triamcinolone acetonide 0.1% cream for flares (refill provided)
Initiate Vtama® (tapinarof) 1% topical cream, applied once daily to affected areas
Start cetirizine (Zyrtec®) at night to help reduce itching and improve sleep
Follow-up scheduled in 2 months
Extensive counseling was provided to the patient’s family, emphasizing:
Skin Care Routine
Bathe with lukewarm water using a gentle, fragrance-free cleanser
Apply moisturizer immediately after bathing
Use thick emollients 2–3 times daily
Avoid scented detergents, soaps, and fabric softeners
Expectations & Education
Families were counseled that eczema is chronic and relapsing, often triggered by:
Dry skin
Weather changes
Scratching
Stress
Scented products
Skin infections
Parents were advised to contact our office if symptoms worsen, fail to improve, or if signs of infection such as yellow crusting or painful sores develop.
Medication counseling included discussion of:
Possible mild burning with topical non-steroidal treatments
Safe use of topical steroids and avoidance of high-potency steroids on the face, groin, or skin folds
Potential side effects of prolonged steroid use, including skin thinning and discoloration
All questions were addressed, and the family demonstrated understanding of the treatment plan.
Comprehensive Pediatric Eczema Care in Katy & Houston
This case underscores the importance of personalized eczema management for children. At Village Dermatology, we offer expert care using the latest treatments—including steroid-sparing topical therapies—to help children achieve long-term skin comfort and healthier skin.
If your child is struggling with eczema or recurrent rashes, our board-certified dermatology team is here to help.
