The addition of a paediatric nurse to a dermatology unit proved extremely useful in providing families with practical advice and reassurance. It also meant that children could be treated in their own homes, rather than admitted to hospital, as Jean Watkins and colleagues explain Atopic eczema is a common problem. In the GP’s surgery, 10-12 per cent of consultations will be related to skin problems and, of those, about 30 per cent are for atopic eczema (Watts 1996). Studies suggest that 80-90 per cent of affected children first develop symptoms before the age of five and that the majority of these show signs of the problem before the age of six months (Holden 1997). This chronic, relapsing, inflammatory skin condition may be just a minor inconvenience for some but many will suffer recurrent and debilitating problems that are not only distressing to the child, but may have severe and stressful repercussions on the whole family.