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Sunday, December 26, 2010

Rashes

Rashes
  • atopic dermatitis (eczema): usually has its onset between two and six months with the development of itchy red areas on the cheeks, forehead, scalp, trunk and on the extensor surfaces of the arms and legs (elbows and knees). The skin may be thickened, shiny and oozing and is usually very dry. Treatment is with daily use of moisturizers and topical steroid creams during breakouts. This is usually a chronic problem that will continue to improve and get worse for many years. See the Eczema Treatment Guide for more information.
  • contact dermatitis: many agents can cause rashes in infants from direct irritation of the skin. These can include harsh soaps and detergents, saliva from excessive drooling, and bubble baths. This type of rash usually has mild redness and itchiness and improves with the use of a moisturizer or lubricant to protect the skin. Many agents can also cause an allergic contact dermatitis with a more intense reaction in the skin 7-10 days after being exposed to it. Common things that can cause allergic skin reactions include poison ivy, cosmetics, and metals. The rash usually is very red, itchy, with oozing, crusting and swelling and will improve with a mild potency hydrocortizone cream.
  • impetigo: a skin infection caused by a bacteria that begins as a tiny red bump and quickly turns into a honey colored crusted plaque. It is most commonly found around the nose, but can occur on any area of skin that has been damaged. Impetigo is treated with antibiotics. For minor infections a topical antibiotic cream can be used, but more extensive cases will require an oral antibiotic.
  • infections: rashes are commonly associated with many different types of viral infections, including roseola (causes high fever for 3-5 days and then once the fever goes away, small red bumps appear on the trunk that spread all over the body), fifth disease(causes red cheeks and then a fine lacelike red or pink rash on the arms), and chickenpox (causes small red bumps that turn into vesicles that crust over). See the Guide to Common Infections for more information on infections that can cause skin rashes.
  • keratosis pilaris: causes small pinpoint size red bumps and rough and dry skin on the cheeks and the back of the upper arms and legs. It is a chronic condition that is difficult to treat, but may improve with lubricants and treatment with topical keratolytic creams, such as Eucerin Plus or LacHydrin.
  • miliaria (heat rash or prickly heat): there are two forms of miliaria,miliaria crystallina, which consists of small clear fluid filled vesicles that rupture and leave behind some scale, and miliaria rubra, which have similar clear fluid filled vesicles, but they are surrounded by red areas. Miliaria is most common on the head, neck, upper chest and in skin folds and is due to blockage of the sweat ducts in the skin. It will resolve on its own, but can be prevented by reducing heat and humidity and not dressing your newborn in tight clothing.
  • molluscum contagiosum: this is a type of wart caused by a virus. The rash consists of small flesh colored, dome shaped bumps with a crater in the center. They can be grouped on any skin surface, but are usually located on the head, neck and diaper area. Treatment is not required and this type of wart will go away on its own over several months to years. Treatment for more extensive or persistent warts can be treated with cryotherapy. An antiviral cream called Aldara is currently being tested in children to help with this common problem.
  • neonatal acne: this is a rash that looks like acne in older children and it is thought to be caused by hormonal stimulation. It usually begins between two to four weeks of age and resolves on its own over the next few months. Severe cases may need to be treated with 2.5% benzoyl peroxide or other keratolytic creams.
  • ringworm (tinea corporis): a fungal infection that causes circular or annular shaped, red scaly patches with clear centers. It is usually found on non-hairy areas of the face, trunk, arms and legs and is easily treated with an OTC antifungal cream applied twice a day for two to four weeks.
  • seborrheic dermatitis: causes yellow or salmon colored greasy scales and patchy redness on the scalp (cradle cap), face, behind the ears and in skin folds. Most children clear up without treatment in three to four weeks, but more severe or persistent forms can be treated with an antiseborrheic shampoo or a low potency topical steroid cream.
  • transient neonatal pustular melanosis: causes tiny 1-2mm pustules to occur on the face, neck, extremities, palms and soles. These pustules are present at birth and can have some scale around them, but they are not red or inflamed. The pustules rupture in the first few days of life and leave behind flat dark areas that resemble freckles. These areas will fade in three weeks to three months without treatment.

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