a) assess compliance with administration and dosage of cream.

a) True _ _ _ _ _ _ _ _ _ _ Correct. Anything else? ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯

b) culture the surface of the lesions.

b) True _ _ _ _ _ _ _ _ _ _ Correct. Anything else? ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯

c) treat the child with oral cloxacillin 25-50 mg/kg x 10 days.

c) True _ _ _ _ _ _ _ _ _ _ Correct. Anything else? ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯

d) use topical fusidic acid cream or mupirocin tid x 10 days.

d) True _ _ _ _ _ _ _ _ _ _ Correct. Anything else? ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯

Answer and Commentary _ _ _ _ _ _ _ _ _ _ a, b, c or d. Significant flare of chronic atopic dermatitis is most commonly associated with superinfection with S. aureus. Although compliance may be a concern, most likely the lesions have been colonized with S. aureus. Systemic antibiotics such as cloxacillin are usually prescribed for extensive secondary skin infections, but topical antibiotics are useful and effective for localized infections. Topical therapy with agents such as fusidic acid and mupirocin provide high concentrations at the site of infection, are easy to use and have minor side effects. ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯