Information for Sam’s mother/father to give during case history

1. You are 32 years old, married to Sam’s mother/father (delete as appropriate). You have an
18 month old daughter who does not have eczema, and you are expecting a baby (30 weeks
gestation).

2. You and your husband/wife are both in good overall health. Your husband/wife has a history
of eczema in childhood and mild asthma, and you have allergic rhinitis that is well controlled
with nasal sprays. You both work as teachers.

3. Sam first developed skin problems at about 2 months of age. You took him to your GP who
told you Sam had eczema and advised using moisturizers and avoiding bathing. His eczema
continued to worsen so you took him to another doctor who prescribed 1% hydrocortisone

4. Despite using 1% hydrocortisone sparingly every day Sam’s eczema continued to get worse
and he became more and more fretful. His sleep became very disturbed as he was scratching
all night, sometimes so much that there was blood on the sheets. You put his hands in
mittens overnight to prevent him damaging his skin. Sometimes you bring him into your bed
to try to stop him scratching at night.

5. Sam has had recurrent skin infections and was admitted to hospital when he had chickenpox
as his eczema flared severely. He has been on many courses of oral antibiotics and oral
steroids.

6. You are confused about whether or not Sam has allergies that are causing his eczema. He
has never had a reaction to a food, but you saw an advertisement for allergy testing using
hair samples in your local pharmacy for €300, so you had Sam tested. The tests showed that
he was allergic to lactose, wheat, chicken, and lamb, even though he always ate those foods.

7. You are very frustrated with all the different advice you have received from family members
and healthcare professionals. One doctor said to use a much stronger steroid cream to get
the eczema under control. However, when you went to collect the prescription, it said you
should only use it sparingly, so you were too afraid to use it.

8. There have been some concerns about his development and growth, as he is currently on
the 25th centile for height but 9th centile for weight. His speech was slightly delayed but he
has now caught up.