It involves the disruption of the epidermal barrier and dry regulation of the immune system.

It is usually triggered by the presence of an allergen.

The epidermis is the outermost protective layer of epithelial cells.

Stratum Corneum - outermost region of epidermis, contains flattened, dead, keratinised cells.

Stratum Lucidum -flattened, anucleate cells, present in thick skin.

Stratum Granulosum -very thin layer, flattened cells, keratinisation begins in this layer.

Stratum Spinosum- spiny or slender projections, cells from SB pushed into this layer, contains keratinocytes.

Stratum Basale - closest to blood supply, next to basement membrane, melanocytes and keratinocytes.

The dermis is a bulk of skin, tough leathery layer of fibrous connective tissue. It is vascularised with nerves fibres and lymphatic vessels. It has 2 layers the superficial papillary layer and deeper reticular layer.

The function of the skin is to provide protection from pathogens.

The skin is also made up chemical, physical and biological barriers.

Ensure that any medication or topical treatments don’t have any animal derived products because they adhere to the kosher diet

Ensure that you give dignity and privacy to patients since eczema may affect many different parts of there body, ask them is they are comfortable showing you they’re eczema as they may prefer a certain gender looking after them

Consider booking an interpreter if the family do not speak English, this will help the nurses educate the family further, and explain to them the their care plan

Parents who also suffer from eczema or have allergies or asthma put their children at a higher risk of also developing eczema one day.

Eczema happens due to a defective skin barrier, and is associated with the development of food and environmental allergies.

Eczema can be triggered by numerous different factors ranging from food such as dairy products, to extreme weather conditions

First signs of eczema are itchiness, dry skin and a rash but can be avoided for some by identifying environmental factors and acting quickly to prevent flare ups

• Topical calcineurin inhibitors, phototherapy, and ciclosporin are less suitable for the acute treatment of flares.

• Bandaging and oral corticosteroids are unsuitable for maintenance treatment.

Mild atopic eczema: emollients - mild potency topical corticosteroids.

Moderate eczema: emollients - moderate potency topical corticosteroids - topical calcineurin inhibitors (tac or pimecrolimus) - bandages.

Severe Eczema: emollients - topical corticosteroids - topical calcineurin inhibitors (tac or pimecrolimus)- bandages - phototherapy - oral corticosteroids

Therefore, Physically our patient can be affected with pain due to the itching and scratching as well as with impared sleep due to the frustration,the pain and the itching

Their cognitive development can be affected as they may struggle at school, due to not being able to concentrate because of the itching and how desperate it can make someone feel, so they may start to fall behind

Socially, their self esteem might seriously be affected, especially when they have flareups, this is because it affects the way their skin look and they might feel embarrassed or contagious so they will avoid socialising.

Emotionally they might be affected because they might feel inferior and insecure about the way they look, they will also feel frustrated and upset due to constantly being in pain and having a horrible itch.