Eczema
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Learn about Eczema

Eczema self-assessment

Proper diagnosis of eczema can be difficult and requires a visit to your physician. Taking the survey below prior to your appointment will help prepare you for some of the questions your doctor may ask about your condition. Simply check the boxes that apply to you and click “Submit”; you’ll get an easy-to-follow page that you can print out and take along to your next doctor’s appointment.

 

While this survey is designed to be a helpful reference tool, it is important to remember that only your doctor can weigh the risks and benefits and determine the right medication for you. Talk to your doctor and ask about Protopic. 

 


Please check all boxes that apply:
My affected skin areas include:

Face
Neck
Chest
Arms
Elbows
Hands
Legs
Knees
Feet

1. Does the affected skin itch?
Yes
No


2. Does the affected skin 'flare up' from time to time (are there periods of more/less itching)?
Yes
No


3. Is the affected skin frequently dry?
Yes
No


4. Is the affected skin red?
Yes
No


5. Are there rashes on the hands, feet, or face?
Yes
No