RT Journal Article SR Electronic T1 A 12-year-old girl with eczema not responding to treatment JF Canadian Medical Association Journal JO CMAJ FD Canadian Medical Association SP E160 OP E162 DO 10.1503/cmaj.151540 VO 189 IS 4 A1 Pennal, Alexandra A1 Pope, Elena YR 2017 UL http://www.cmaj.ca/content/189/4/E160.abstract AB A 12-year-old girl, who has had a history of intermittent skin rashes since infancy, presents for the sixth time in four months for exacerbation of eczema that is not responding to recommended treatment (daily baths, frequent moisturization and twice-daily application of medium-potency topical corticosteroids). Her parents express concern about the effect of her skin disease on the child’s life. They are worried about her sleeping difficulties and decreased involvement in her regular activities; for example, she has stopped playing sports and attending school. During the interview, the patient makes minimal eye contact and appears agitated. Her medical history includes allergic rhinitis. She looks systemically well, with normal temperature and vital signs. Skin examination shows generalized xerotic skin and erythematous patches, with predominantly flexural and facial excoriations affecting about half of the body. There is no evidence of burrows, track marks, vesicular or pustular lesions, or honey-coloured crusts. The rest of the exam is unremarkable.