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Dermatology · Papulosquamous disorders: asteatotic eczema
Sample itemAn 80-year-old has itchy, dry, cracked skin on the shins in a pattern resembling a dried river bed during winter. What is the best first-line management?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Regular emollients, short lukewarm baths and a mild topical steroid for flares
Asteatotic eczema or eczema craquele arises from loss of skin lipids and low humidity in older adults. Treatment restores the barrier with emollients and soap substitutes, with a topical steroid for inflamed areas. Systemic therapy is rarely needed.
Option by option
A. Oral prednisolone for 4 weeks
Oral steroids are unnecessary for this localised dry skin eczema.
B. Phototherapy
Phototherapy is not used for simple xerotic eczema.
C. Oral antibiotics
Antibiotics are only needed for secondary infection.
D. Regular emollients, short lukewarm baths and a mild topical steroid for flares (correct)
Correct. Barrier repair with emollients and a mild steroid is first-line.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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