What should I do if my eczema becomes feverish and itchy at night?

Eczema that causes fever and pruritus at night requires treatment tailored to its underlying cause and clinical presentation, primarily categorized as acute, subacute, or chronic eczema.

1. Acute eczema: When there is significant exudation, wet compresses with nitrofurazone solution or compound Phellodendron solution are recommended. After wet compresses, purple gromwell oil may be applied topically, and ulcer aerosol spray may be used. If the acute eczema presents only with erythematous papules and no exudate, calamine lotion may be applied topically.

2. Subacute eczema: When exudation is minimal, purple gromwell oil may be applied topically. In cases without exudation, topical corticosteroid ointments—such as mometasone furoate (Elocon) or prednicarbate (Plicamycin)—may be used; however, corticosteroids should be avoided in children and on the face.

3. Chronic eczema: Characterized by lichenified, thickened skin changes. In such cases, potent topical corticosteroid ointments—e.g., flumethasone—are indicated.

Eczema is commonly associated with allergic reactions; therefore, systemic antihistamines—such as loratadine or levocetirizine hydrochloride—are frequently prescribed. For severe eczema, oral or intravenous corticosteroids may be added.