Dr. Dhepe Snehal Madhav
Venereology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My 14-month-old daughter has flare-up rashes. The rashes started last, and she still has them at the minute. We have been giving her Allerief liquid, it seems to reduce after the medicine, but it will then return after a couple of hours. She does not show any other symptoms and still seems well, but the rash is quite severe. We have tried to eliminate nappies, milk, washing powder, etc. However, it does not seem to be making any difference. Could you advise on anything we could do? Thanks.
Hi,
Welcome to icliniq.com.
The differential diagnosis is irritant contact dermatitis and urticarial rash. Apply Desonide cream at night for ten days. Also apply Lacto Calamine, lotion thrice daily for ten days.
Do you have any history of fever? Is it widespread or localized to the diaper area? Do you have any history of atopy? Did you experience a similar episode in the past?
Please do reply.
Patient's Query
Hi doctor,
Thank you for your responses. Do you know what might be causing this, please?
Hi,
Welcome back to icliniq.com.
It is atopic dermatitis, a widespread allergic response in babies or infants to allergens or irritants.
The cause can be external stimuli, ammonia in urine (diaper contact dermatitis), or dietary protein. I suggest using Desonide cream or Cutisoft (Hydrocortisone) cream at night for ten days. Also, use Physiogel Hypoallergic Al cream once in a day. Atogla (gamma Linolenic acid, Ceramides, Aloe vera, Wheat Germ Oil, and Glycerin) lotion or Lacto Calamine lotion thrice daily for ten days. Give Atarax (Hydroxyzine Hydrochloride) syrup 2.5 ml two times a day.
Avoid cow milk or related formula milk, egg, and groundnuts. Frequently change diapers. Take care of the skin by washing in gentle lukewarm water.
Do your parents have a history of atopy? Does the flare-up of atopic dermatitis occur with a change in weather? Is there any seasonal aggravation? Did you use strong soaps? Did you use any new cosmetic products like powder, cream, or scented fragrance lotion? Is she allergic to woolen clothes, dust, or pets in the house? Does she have any history of drug allergy to Amoxicillin or any other drug? Does she have any history of fever? Is the she rash localized to the diaper area or widespread? Please answer these questions.
Patient's Query
Hi doctor,
Thank you so much doctor for your reply.
No, there is not a fever, but she does have diarrhea. It is widespread, but it does seem to be more severe in the diaper area. It is on the cheeks, arms, and legs. There is no history of it in her or the family, and it never happened before. Could it possibly be a virus? The anti-allergy medicine takes it away more or less straight away. Would it do this if it was a rash caused by a virus? She always drinks cow's milk. This is a photo of how it was this morning when she woke up, without giving her any medicine.
Thanks.
Hi,
Welcome back to icliniq.com.
Three to four times the frequency of semi-solid to solid-stools are normal. Stop any new food which you have started giving her recently. Maintain proper hygiene of bed linen and clothes. Stay away from pets, if any. Diarrhea with the rash can be a viral infection (rotavirus).
Please answer these questions. Are there any pets at home? What is the frequency of stools? Do the symptoms of diarrhea and rash started together at the same time? Is there excessive, unreasonable crying of the baby?
Patient's Query
Hi doctor,
Thank you, doctor, for your reply.
No, we do not have any pets. It seems to flare up when the baby is asleep in her cot or the pram. When she wakes up from the sleep, the rash has returned. We have washed all her clothes and bed linen on a 60-degree wash with no washing powder. Cut all dairy from her diet. She is doing one stool per day, but it is not like her normal stools. She still seems fine in herself and has no temperature. What do you think it could be?
Hi,
Welcome back to icliniq.com.
It is atopic dermatitis (allergic rash) due to extrinsic allergen. Clean the pram and baby linens or clothes regularly. An anti-allergic drug will suffice.
Apply Desonide (Aluminum acetate basic, Cetearyl alcohol, Glycerin) cream at night for ten days, Atarax (Hydroxyzine) syrup half teaspoon twice daily for five days, Atogla lotion (moisturizing lotion) twice daily for ten days. Or Calamine (zinc carbonate and ferric oxide) lotion twice daily for ten days.
I have few questions, please answer. Are the stools foul-smelling? Is the stool are greenish-brown watery in color and consistency? Is there any history of an insect bite? Does the baby have any mite allergies? Is the baby is allergic to woolen clothes?
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Venereology
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