Hello and welcome to the Zero to Finals podcast. My name is Tom, and in this episode, I'm going to be talking to you about Exma.

And you can find written notes on this topic at zero definals.com slash Exma or in the dermatology section of the Zero Definals Pediatrics book.

So let's get straight into it.

Exma is a chronic atopic condition caused by defects in the normal continuity of the

skin barrier which leads to inflammation in the skin. There is a genetic component to

exma and it tends to run in families. However, there's no single inheritance pattern. There's a genetic component to Exma and it tends to run in families, however there's no single

inheritance pattern.

There's significant variation in the severity of the condition.

Some patients have very occasional mild patches that respond well to emolence, whereas other

patients have large areas of skin that are severely affected and inflamed and require strong topical

steroids or systemic treatments to control. Exma typically presents in infancy with dry, red, itchy

and sore patches of skin over the flexor surfaces, the insides of the elbows and the knees, and on the face and the neck.

Patients with exma experience periods where the condition are well controlled

and other periods where the exma is more problematic, which are known as flares.

So briefly, let's discuss the pathophysiology.

The simplified pathophysiology is that eczema is caused by defects in the barrier that the

skin provides.

Tiny gaps in the skin barrier provide an entrance way for irritants, microbes and allergens.

When these things get into the skin, they stimulate an immune response,

resulting in inflammation and associated symptoms. Next, let's discuss management. Management of

Exma can be thought of as maintenance and management of flares, similar to the management

of chronic and acute asthma. The key to maintenance is to

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