PT - JOURNAL ARTICLE AU - Laureen Jacquet AU - Daisy M Gaunt AU - Kirsty Garfield AU - Matthew J Ridd TI - Diagnosis, assessment, and treatment of childhood eczema in primary care: cross-sectional study AID - 10.3399/bjgpopen17X100821 DP - 2017 May 02 TA - BJGP Open PG - BJGP-2017-00821 4099 - http://bjgpopen.org/content/early/2017/04/28/bjgpopen17X100821.short 4100 - http://bjgpopen.org/content/early/2017/04/28/bjgpopen17X100821.full AB - Background The majority of children with eczema in the UK are looked after in primary care yet we know little about their care in this setting.Aim To compare the diagnosis, assessment, and treatment of eczema in primary care with published diagnostic criteria and management guidelines.Design & setting Cross-sectional study using data from a randomised controlled feasibility study. General practices, UK.Method Baseline data from children aged 1 month to 5 years recruited ‘in-consultation’ for the Choice of Moisturiser in Eczema Treatment (COMET) feasibility study was used. These included clinician diagnosis and global severity assessment; the parent-completed Patient Orientated Eczema Measure (POEM); a questionnaire about eczema treatments, including use of topical corticosteroid (TCS); and, the Eczema Area Severity Index (EASI) carried out by trained researchers. Descriptive analyses were undertaken to compare diagnoses with UK diagnostic criteria, severity assessments, and treatment with the National Institute for Health and Care Excellent (NICE) guidance.Results Data were available for 90 participants. Only 46% of participants labelled as having eczema met the UK diagnostic criteria. Agreement between the global severity assessment by a healthcare practitioner with the EASI and POEM measures of eczema severity were 44% and 48% respectively. Emollients and TCSs were underused with 44% of participants not using any emollient and 46% using one or more TCSs. The ‘match’ between eczema severity and TCSs potency was poor.Conclusion Discrepancies were found between the diagnosis, assessment, and treatment of children with eczema in primary care, and UK diagnostic criteria and guidelines. Further investigation to explore the reasons for this discordance, and whether it matters, is needed.