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APPENDIX 7

PRIMARY CARE INFORMATION SHEET The Combined Approach ('Habit Reversal') for Atopic Skin Disease The approach was introduced in 1989 at the Daniel Turner Clinic, Westminster Hospital. For out-patients with atopic eczema, it combines conventional topical treatment with a behaviour modification technique called habit reversal. This procedure aims to eliminate self-damaging behaviours characteristic of chronic eczema, such as repetitive scratch­ ing and rubbing. The Combined Approach is suitable both for children and adults. • All referrals from general practitioners are first assessed dermatologically before being considered appropriate for the Combined Approach. The programme then requires a series of appointments for: Assessment, Introduction of treatment, Review of treatment, and Follow-up. From assessment to beginning follow-up takes between five and seven weeks. Follow-up can continue for several months with appointments at six weeks, three and six months. • The Combined Approach aims to educate all patients in the rationale for and the appropriate use of emollients and topical steroids. In addition, following a week's measure­ ment of the frequency of self-damaging behaviour, habit reversal procedures are taught. Throughout the programme there is an emphasis on positive self-care, and the avoidance of risk factors. • The Combined Approach eliminates the chronic syndrome of long-standing atopic skin disease. Patients then only require intermittent treatment of acute relapses, using a treatment schedule that can easily be followed in primary health care. Both patient and general practitioner receive written advice on the required procedures. Further advice is available at follow-up.

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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