Eczema / Atopic Dermatitis

Eczema is a broad clinical term for inflammatory dermatitis, but in most nursing and primary care education it refers primarily to atopic dermatitis. At the NP level, eczema should not be taught as “dry itchy skin” alone. It is a chronic, relapsing inflammatory skin disease driven by impaired epidermal barrier function, immune dysregulation, pruritus, environmental triggers, microbiome changes, and recurrent skin injury from scratching. The Canadian Dermatology Association describes eczema as a non-contagious inflammatory skin condition that cannot be cured but can be managed with flare control, moisturization, medications, and trigger reduction. The NP role extends beyond reinforcement of skin care. The NP must assess pattern and severity, diagnose likely dermatitis subtype, distinguish mimics, identify complications, prescribe appropriate topical therapy within scope, recognize when systemic or specialist therapy is needed, manage comorbid allergic disease, counsel against unsafe treatment practices, and create a realistic long-term maintenance and flare plan. Current dermatology guidance supports moisturizers, topical corticosteroids, topical calcineurin inhibitors, and other topical anti-inflammatory therapies for atopic dermatitis; systemic and phototherapy options are considered when disease is refractory to topical care.