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3. 4. 5. 6.

Percentage scratching from itch. 0-10 severity? Where mostly? Where otherwise? Percentage old vs. new.

0 r

Three levels of treatment review Level 1: Emollients. Level 2: Steroids — check use of booklet. Level 3: Habit reversal — specific measures, adaptions introduced, general measures. Review rationale answer questions

check

any

understanding,

Review day and night behaviour, using 1 2 hour clock faces • draw diagrams and indicate by shading-in when patient 'most at risk'. Discuss strategies for focal attention in next period of home treatment. Demonstrate small proportion of day equals most damage done. Establish target frequency for scratching to be achieved by next visit.

The healing curve' Use graph drawn with patient to illustrate 'healing curve' compared with fluctuating chronic atopic skin disease — show three levels of treatment produce 'healing curve': emphasise all levels require active patient participation.

Trouble shooting Is stress significant factor? Review methods of coping — give written suggestions. • Forgotten areas, e.g. scalp? • Infections? • Sensitivities?

End of third visit • •

Review continuing treatment instructions. Replenish record sheets as necessary.

Visit Four • •

Review 6 measures (see beginning of third visit) . Review three levels of treatment (see third visit).

O f ••

Profile for Christopher Bridgett

Atopic Skin Disease - A Manual For Practitioners  

An account of a new behavioural approach to the treatment of atopic eczema, written for practitioners, but also for patients

Atopic Skin Disease - A Manual For Practitioners  

An account of a new behavioural approach to the treatment of atopic eczema, written for practitioners, but also for patients