<p>This case study describes the management of an 11-year-old boy living in the desert in Saudi Arabia who was diagnosed with severe eczema. The traditional therapy used by a local physician to treat this common disease had negatively affected his management. Recommendations are made to improve the future treatment of skin conditions in rural areas, such as the need for more coordination with secondary and tertiary centres, regular follow-up supported by educational programmes and better diagnosis and management.</p>