Skill Checkup: An 11-Year-Old Girl With Severe Nighttime Itchiness

Diamant Thaçi, MD, PhD


April 14, 2022

The Skill Checkup series provides a quick, case-style interactive quiz, highlighting key guideline- and evidence-based information to inform clinical practice.

An 11-year-old White girl accompanied by her mother complains of severe nighttime itchiness that interrupts sleep. The girl has a pruritic, erythematous, eczematous rash on her face, flexural areas of the neck, chest, and palms, and flexural areas of the knee. The estimated total body surface area (BSA) affected is 15%.

She has had atopic dermatitis (AD) since infancy, but her symptoms have worsened and are more continuous in the past year (flares every 4-6 wk). She has occasional seasonal allergies. She is on her school's soccer team but has lost interest in this because she is embarrassed about her appearance.

Her mother has treated her AD with emollients and warm baths since infancy. She has not brought her daughter in for a consultation before.


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