Monkeypox is a rare infection that appears on the skin as raised spots, which turn into small blisters filled with fluid. These blisters eventually form scabs, which later fall off. The skin symptoms of monkeypox have the potential to be confused with infected eczema, particularly eczema herpeticum, which is a serious viral herpes infection. For more information on the other symptoms of monkeypox, which appear before the skin symptoms, please see the NHS website. For more information on eczema herpeticum, please see this page.

Children and adolescents with a history or presence of atopic eczema are at risk of more severe monkeypox. If you suspect that you or your child has monkeypox – or eczema herpeticum – please seek immediate same day medical advice.

Monkeypox vaccine (MVA-BN) and cautions for people with eczema

The vaccine recommended to protect against monkeypox is a third generation Modified Vaccinia Ankara (MVA) vaccine, which was first developed in the 1950s for the prevention of smallpox. See the UK Health Security Agency (UKHSA) website for more information. For most people, the monkeypox vaccine has a favourable safety profile.

People with atopic eczema, though, may be more likely to experience certain side effects from the vaccine. These include more intense local skin reactions (such as the skin becoming red or darker than usual, depending on skin tone, swelling and itching) and other general symptoms (such as headache, muscle pain, feeling sick or tired), as well as a flare-up or worsening of their eczema. In rare cases, people with atopic eczema have experienced serious reactions to the vaccine with widespread infection of the skin.

National Eczema Society and the UKHSA recommend that people with atopic eczema seek a risk assessment before taking the vaccine in order to balance the risk from exposure to monkeypox and the risk of possible side effects from vaccination.

The MVA vaccine is currently being offered to people in the UK at high risk of exposure to monkeypox. Note there have been challenges reported in obtaining sufficient supplies of the vaccine (as of August 2022). The UKHSA recommends MVA is offered to:

  • healthcare workers caring for patients with confirmed or suspected monkeypox
  • men who are gay, bisexual or have sex with other men, and who have multiple partners, participate in group sex or attend sex on premises venues. Staff who work in these premises may also be eligible
  • people who have been in close contact with someone who has monkeypox – ideally they should have the vaccine within 4 days of contact, but it can be given up to 14 days after.

References

Tuesday 13 September, 6:00 – 6:45pm

Register for the webinar here.

In this webinar, Dr Paula Beattie will talk about how topical steroids can be used safely and effectively to manage eczema inflammation. She will also address concerns over the safety of topical steroids, including topical steroid withdrawal.

Dr Beattie is a Consultant Dermatologist and Honorary Senior Lecturer at the Royal Hospital for Children in Glasgow, and a member of National Eczema Society’s Medical Advisory Board.

Thursday 15 September, 4:30-5:30pm

Register for the webinar here.

National Eczema Society and St John’s DermAcademy are pleased to collaborate to bring you this free webinar of informative talks from experts at the forefront of eczema research and practice. In this webinar, dermatology experts will explore allergy and eczema, and how to help children break the eczema itch-scratch cycle using the habit reversal technique. There will be time after the talks for you to ask questions of the panel.

4:30pm Welcome and overview of the evening
Professor Carsten Flohr

4.35pm Fact-checking allergy myths
Dr Tom Marrs

4.50pm How children can break the eczema itch-scratch cycle using the habit reversal technique
Dr Susannah Baron

5:05pm Question and answer session with a panel including webinar speakers, plus Rukshana Ali, Maria Akinde, Sarah Guard, and Andrew Proctor, Chief Executive of National Eczema Society. Participants are encouraged to ask questions on the topics being presented, as well as other areas of eczema care.

5.30pm Close

Webinar speakers and panel

Professor Carsten Flohr

Professor Carsten Flohr
St John’s Institute of Dermatology
Guy’s & St Thomas’ NHS Foundation Trust and King’s College London

Professor Flohr studied at Cambridge and Oxford Universities and then trained in both paediatrics and dermatology.

He was the first UK National Institute for Health Research (NIHR) Clinician Scientist in Dermatology (2009-2014) and the only dermatologist awarded a Career Development Fellowship from the NIHR (2014-2019).

Professor Flohr directs the Unit for Population-Based Dermatology Research at St John’s Institute of Dermatology, King’s College London, where he holds the Chair in Dermatology and Population Health Science.

He has a particular interest in novel methods of atopic dermatitis (AD) prevention (early life risk factors) and therapeutics, especially in severe AD.

He is Chief Investigator of the UK-Irish TREatment of severe eczema in children Trial (TREAT), which compares cyclosporine with methotrexate in children with recalcitrant atopic eczema. He is also Chief Investigator of the Softened water for eczema prevention trial (SOFTER), the UK-Irish Atopic Eczema Systemic Therapy Register (A-STAR), and the EU-funded TRANS-FOODS consortium.

Professor Flohr is a Founding Director of the International Eczema Council and Past President of the British Society of Paediatric Dermatology.

He leads the European treatment guideline for atopic eczema.

He is also Founding Editor of the Evidence-Based Dermatology Section of the British Journal of Dermatology and the Clinical Trials Editor of the F1000 Atopic Dermatitis Section.

Dr Tom Marrs

Dr Tom Marrs
Consultant in Paediatric Allergy, St Thomas’ Hospital, Guy’s and St Thomas’ NHS Foundation Trust
Director of the Allergy Academy, King’s College London
Senior Honorary Lecturer in Paediatric Allergy, School of Immunobiology, Faculty of Life Sciences and Medicine, King’s College London

Dr Marrs is a Consultant in Paediatric Allergy working in the Children’s Allergies Department at St Thomas’ Hospital. He read Medicine, Psychology and Medical Law at Clare College Cambridge, before completing his clinical training at St Bartholomew’s and the Royal London Medical School.

Dr Marrs joined King’s College London as part of the team running the Enquiring About Tolerance (EAT) Study. This randomised trial showed that the regular consumption of peanut and egg by infants can prevent the development of peanut and egg allergy. He continued his clinical research as a Clinical Lecturer at King’s College London to investigate how the microbiome and lifestyle factors such as bathing and pet ownership may influence the development of allergic disease.

As a Consultant in Paediatric Allergy as St Thomas’ Hospital, Dr Marrs leads the Peanut Introduction Service as well as the Joint Allergy Gastroenterology service. He is Director of the Allergy Academy from within King’s College London, which is the largest post-graduate institute for post-graduate allergy teaching in the UK.


Dr Susannah Baron

Dr Susannah Baron
Consultant Dermatologist, St John’s Institute of Dermatology
Guy’s and St Thomas’ NHS Foundation Trust

Dr Baron is a Consultant Dermatologist working at the St John’s Institute of Dermatology. She specialises in Paediatric Dermatology and has established a multi-disciplinary paediatric psychodermatology service at St Thomas’ Hospital where together with a Clinical Psychologist she manages children with psychological distress associated with their skin disease and psychological disorders presenting with skin signs.

Dr Baron’s other field of expertise is in the management of severe eczema in children where she manages the psycho-social impact on children and families alongside the severe eczema. She is involved in population-based research and clinical trials in severe eczema and current ongoing studies are using the newer biologic agents and research exploring the interaction between mind and skin is in the early stages.

Dr Baron is current Chair of Psychodermatology UK and Treasurer of the British Society of Paediatric Dermatology.

Panel

Dr Rukshana Ali

Dr Rukshana Ali
Clinical Psychologist, St John’s Institute of Dermatology
Senior Psychologist, Evelina Children’s Hospital
Guy’s and St Thomas’ NHS Foundation Trust

Dr Ali is the Clinical Psychologist within the Paediatric Dermatology team at the St John’s Institute of Dermatology. She is also a senior Psychologist within the Evelina Children’s Hospital and leads the Evelina Trauma Service. She qualified with her doctorate in Clinical Psychology (DClinPsy) from Royal Holloway, University of London and holds a Postgraduate Diploma in Cognitive Behavioural Therapy.


Dr Ali has extensive experience in working with long term health conditions with children and adults. She has contributed to research, publications and conference presentations concerning the role of psychology and psychological wellbeing in dermatology, weight management, surgery and bariatric surgery. She has a specialist interest in psychodermatology and the psychological wellbeing of people living with skin conditions. She currently sits on the Psychodermatology UK executive committee.

Maria Akinde

Maria Akinde
Paediatric Dermatology Clinical Nurse Specialist
St John’s Institute of Dermatology

Maria Akinde is a paediatric dermatology clinical nurse specialist in St John’s Institute of Dermatology at Guys and St Thomas’ Hospital. She completed her undergraduate nurse training at King’s College London where she obtained a BSc in Adult Nursing. She has 10 years of experience in dermatology, providing a range of specialist dermatology care to adult, adolescent and paediatric populations. She runs nurse led clinics for paediatric and adolescent patients living with chronic conditions, incorporating a holistic, patient/family orientated and practical approach to management regimes that are achievable and facilitate age-appropriate self-management, where possible. Maria is experienced in the use of systemic and biologic therapies for paediatric and young patients with eczema, psoriasis, HS amongst others and is also involved in the paediatric severe eczema and psoriasis clinic. She plays a key role in communicating between families and multi-disciplinary teams for patients with complex medical, social and psychological needs. Maria was nominated by her colleagues for the GSTT Staff Nurse of the Year in 2016 and twice for the RCN’s rising star award in 2020 and 2021.

Sarah Guard

Sarah Guard MPharm (Hons) PG Dip GPP
Independent Pharmacist Prescriber
Highly Specialist Clinical Pharmacist – Dermatology and Allergy
Guy’s and St Thomas’ NHS Foundation Trust

Sarah is a highly specialist clinical pharmacist in dermatology and allergy. Her areas of expertise include pharmaceutical management of severe psoriasis and eczema, non-medical prescribing (prescribing of biologics in psoriasis), medicines management, medicines information in dermatology and allergy, commissioning and funding requests.

New study finds low treatment satisfaction, poor control of eczema symptoms, high psychosocial burden and clear gaps in patient-centered care for eczema patients worldwide.

The Global Patient Initiative to Improve Eczema Care (GPIIEC), a partnership of eleven patient organizations, today (6 April 2022) released a global report of eczema patient care in eight countries: Australia, Canada, Denmark, France, Italy, Germany, United States, and the United Kingdom. National Eczema Society contributed views and experiences of people with eczema from the UK.

The Initiative is a global collaboration to establish common measures to assess the responsiveness of health systems to the needs of patients and their caregivers, and to identify opportunities for improvement.

Eczema is a long-term relapsing inflammatory skin condition that impacts approximately 15% to 20% of children and 1% to 3% of adults globally, resulting in a significant patient burden and high demand on health care systems. A global survey by the GPIIEC that received over 3,000 responses found that patients in every country, and particularly those who lived with moderate to severe eczema, are struggling to achieve long-term control of their eczema symptoms and report limited satisfaction with current treatments.

Survey respondents from the UK, both adults and parents of children with eczema, reported the lowest or low scores on the measures for long-term control of eczema symptoms, satisfaction with eczema treatments, patient education, shared decision making and life span trade-off.

Poorly controlled eczema, which does not respond well to current treatments, has a substantial impact on patients’ health-related quality of life. Based on adult patients’ descriptions of their health, they would be willing to sacrifice between 18-38% of their remaining life span in order to be restored to perfect health. Key drivers of lower quality of life were the pain and discomfort of eczema and the mental health impacts such as anxiety and depression.

Moderate to severe eczema is complex and chronic, demanding a high degree of patient involvement in ongoing symptom management. However, education and training for this role is minimal and patient input into treatment decisions is lacking in almost every country surveyed. Interestingly, shared decision making, defined as asking patients and caregivers about their priorities during a medical visit, was predictive of symptom control. This finding suggests that such involvement may improve medical care and outcomes, and serves as a target for improvement for health systems in each country.

About Global Patient Initiative to Improve Eczema Care (GPIIEC)
GPIIEC is a patient organization-led effort to measure the performance of health systems in meeting the needs of people with eczema (atopic dermatitis) and their caregivers using a common methodology to allow for direct comparisons. For more information: www.improveeczemacare.org

This event is organised by the West Surrey and NE Hants Support Group.

When?

2:00pm, Saturday 26 March 2022

Where?

The Pavilion
Woodbridge Road
Guildford
GU1 4RP

Speaker:

Dr George Moncrieff, General Practitioner and Past Chair of the Dermatology Council for England, will give a short presentation followed by questions and answers.

Admission free; donations welcome! No booking needed – just turn up on the day.

Phone 01483 827668 or 01483 567668 for directions if required.

Update, January 2022

On Tuesday 25 January at 4:30pm there will be a Westminster Hall debate on the All Party Parliamentary Group on Skin (APPGS) report on Mental Health and Skin Conditions published in 2020. The debate is only open to MPs and visits to the House are currently suspended, but it will be available to watch on Parliament TV: https://www.parliamentlive.tv/.

23 September 2020

National Eczema Society was very pleased to see the publication of a major new report on mental health and skin disease, produced by the All Party Parliamentary Group on Skin (APPGS).

This looks at the mental health support available to people with skin conditions in the UK and the psychological impact of living with these conditions. It provides evidence of the urgent need for more and better services to support people with the mental health impact of skin conditions like eczema, which can be so debilitating.

Almost all the patients (98%) who took part in an APPGS survey earlier this year said their condition affects their emotional and psychological wellbeing. Five per cent reported having suicidal thoughts. Over half of the patients surveyed did not realise specialised support was available for people with skin conditions, in the form of psychodermatology.

National Eczema Society contributed to this important report and helped promote the patient survey. Thank you to everyone who took part and a number of powerful anonymised quotes from people with eczema are included in the report. Our wonderful patient advocate, Shal Henry-Treloar, spoke about her family’s experience of eczema and her own challenges at an APPGS evidence-gathering event in Westminster in March.

This APPGS report reinforces many of the findings of the Society’s own Eczema Unmasked survey, which we promoted during National Eczema Week. This also highlighted the mental health impacts of living with eczema and the lack of access to emotional and psychological support services.

The full APPGS report is here.