A 3-month-old infant has erythematous, oozing, crusted patches on the cheeks, scalp, and extensor surfaces of limbs with sparing of the diaper area. Which of the following is the most appropriate initial treatment?
- A Topical tacrolimus 0.1% ointment twice daily
- B Oral cetirizine syrup
- C Topical betamethasone 0.1% cream
- D Emollients and low-potency topical corticosteroid (hydrocortisone 1%) ✓
Explanation
The presentation describes atopic eczema (atopic dermatitis) in an infant: characteristic distribution (face, scalp, extensors) with sparing of the diaper area (a useful distinguishing feature from seborrhoeic dermatitis). First-line management is emollient therapy as the foundation plus a mild topical corticosteroid (hydrocortisone 1% or 2.5%) for active flares. Tacrolimus 0.1% is a second-line calcineurin inhibitor licensed for children ≥2 years and avoided in infants. Betamethasone is a potent corticosteroid unsuitable for infants' thin skin. Antihistamines do not modify the eczematous process.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.