CITIZENS

60 October April/May 2015 2011
Health
Kensington, Chelsea & Westminster Today
www.KCWToday.co.uk
Diagnosing and
treating eczema
in children
It was National Eczema Week
last month, and the National
Eczema Society celebrates its 40th
anniversary this year, so there’s no
better time to look at this very common
condition. Dr Jamal Karwan, a private
GP at Kensington’s Bupa Cromwell
Hospital discusses how best to diagnose
and treat eczema in your child.
Atopic eczema is an inflammatory
skin condition affecting up to 20% of
children; the majority before the age of
five. It is characterised by an itchy red
rash, and although many cases clear up
during childhood, others persist into
adulthood. There are many potential
triggers; soaps and detergents (including
shampoos and bubble baths), skin
infections, dietary factors and allergens
such as pollen, mould and dust mites.
If you have concerns about a red rash on
your child’s skin then the first port of call
should of course be your GP, but what
treatment options are you likely to be
given if eczema is diagnosed?
Government guidelines on atopic
eczema in children recommend a stepped
approach to management, tailored to
the severity of the eczema. Emollients
(creams, oils and ointments) should
always be used, even when the eczema
is clear, but management can then be
stepped up or down according to the
severity of symptoms.
Topical steroids can be used when
emollients alone aren’t effective. The
strength of steroid is determined by
the age of the patient and the site and
severity of eczema. Antibiotics are
reserved for cases of infection in localised
areas and used for no longer than
two weeks.
‘Immunomodulators’, which
modify the immune system to
reduce inflammation, can also be
used when steroids are ineffective
or if there is a risk of side effects
from steroids such as thinning
of the upper layers of skin (skin
atrophy).
Immunomodulators should
be prescribed by a skin specialist,
but your GP may also refer
your child to a specialist if the
eczema is severe or painful, if it
hasn’t responded to emollients or
antibiotics, or if it is leading to
problems like sleep disturbance or
poor school attendance.
Food allergy has a role in 7% of
atopic eczema cases, particularly
in children under three, and is
more likely in this age group if
associated with a rash that appears
around the mouth when eating.
It’s also a possible cause when there are
other gastrointestinal symptoms. Reflux,
vomiting, colic, diarrhoea and food
refusal can all be associated with cow’s
milk protein allergy, as can wheezing and
failure to thrive.
For bottle fed babies under six
months with moderate or severe atopic
eczema (that has not been controlled
by emollients and steroids), a protein
or amino acid based alternative to cow’s
milk formula will often help.
All parents worry about rashes that
appear on their child’s skin, but atopic
eczema is extremely common and usually
easily treated. Book an appointment with
your GP if you have any concerns and
they will put your child on the road to
recovery.
To make an appointment with Dr
Karwan or another General Practitioner
at Bupa Cromwell Hospital,
call 020 7460 5700 or go to:
www.bupacromwellhospital.com.
Predicting
Alzheimer’s
disease
By Fahad Redha
Scientists from King’s College have
developed a blood test to estimate how
quickly someone is ageing. They believe
it could be used to predict a person’s risk
of developing Alzheimer’s disease as well
as the “youthfulness” of donated organs
for transplant operations.
The test measures the vitality of
certain genes to indicate a person’s
biological age, which may differ from
their actual age. A study has shown
that the test can distinguish between
healthy individuals and patients with
Alzheimer’s, meaning it can be used to
identify people in the early stages of the
disease, before symptoms appear.
It could also be used on donated
organs for transplants to assess their
biological age and their risk of failing
James Timmons, Professor of
Precision Medicine at King’s College
London stated. “We use birth year, or
chronological age, to judge everything
from insurance premiums to whether you
get a medical procedure or not.”
“Most people accept that all
60-year-olds are not the same, but there
has been no reliable test for underlying
biological age,”
“Our discovery provides the first
robust molecular ‘signature’ of biological
age in humans and should be able to
transform the way that age is used to
make medical decisions. This includes
identifying those more likely to be at
risk of Alzheimer’s, as catching those at
early risk is key to evaluating potential
treatments,” he added.
Pneumonia
By Fahad Redha
Parliament Square Gardens was
subjected to an unusual protest as 730
bed-bound dolls occupied the green
on September 16th. The eye-catching
installation was designed to represent
each person over 65 hospitalised with
pneumococcal pneumonia every week in
the UK, drawing attention to the burden
it places on the NHS; 400,000 days spent
in hospital at an estimated cost of £124
million per year for hospital care alone.
The installation was commended
for highlighting the strong levels of
existing support for greater action to
tackle this problem. Leading figures in
ageing health and respiratory medicine
gave their backing to the ‘pneumonia
wake-up call,’ and stated that “Adult
pneumococcal pneumonia places a heavy
burden both on patients and the NHS
and these striking images really bring
home the scale of this important public
health issue,”
Without rapid and decisive action to
address this, we are set to face another
winter of heightened pressure on
hospitals, with pneumococcal pneumonia
placing a significant strain on an already
pressurised health system.” commented
Baroness Sally Greengross, Member of
the House of Lords and President of the
International Longevity Centre.
“Pneumococcal pneumonia is often
overlooked, but it can be a dangerous
illness,” Dr Richard Russell, Consultant
Chest Physician, Lymington
New Forest Hospital, added.
“Amongst older adults, who are
more vulnerable to infection,
this type of pneumonia is a
significant reason for hospital
admission and can cause
death. With an increasing,
ageing population, it is vital
that appropriate preventative
strategies are put in place now
to ensure that the vulnerable
are better protected ahead of
winter. Each bed featured in the image
represents one of the hundreds of adults
who will sadly need hospital treatment
each week for pneumococcal pneumonia.
We must take action to protect these atrisk
individuals and their families.”
Three quarters of all pneumonia
cases are admitted through A&E with
pneumococcal pneumonia being the
most common type. Older adults are not
only at a greater risk of infection and
complications but generally spend more
time in hospital than younger adults.
Estimates suggest that preventing just
65 cases of pneumococcal pneumonia
could free up a hospital bed for almost 2
years and save the NHS over £210,000
on hospital care alone. There is therefore
an urgent need for a rapid, transparent
and comprehensive review of current
prevention strategies to help minimise
the impact of this life threatening
infection on the NHS ahead of the
winter peak in the disease.