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Q. My daughter has pink, itchy spots on her elbow that is spreading. How to treat her?

Answered by
Dr. Dhepe Snehal Laul
and medically reviewed by Dr. Chithranjali Ravichandran
This is a premium question & answer published on Dec 28, 2021

Hello doctor,

My 12-year-old daughter has had a skin problem on and off since she was a toddler. We guess it to be eczema. It started in her inner crease of the right elbow as a pink, itchy spot, and it spread to her left hand in between her middle fingers and palm. The skin is pink, peels off, and is itchy. I have tried many creams, lotions, soaps, and medicines that are available over the counter. But nothing helped. She does not have any known allergies before.

I have attached the pictures.

Kindly help.

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Hello,

Welcome to icliniq.com.

I have seen the pictures you sent (attachments removed to protect the patient’s identity).

It is hand eczema (dermatitis). Dermatitis is confined mainly to hands with or without minor involvement of other areas. The disease can be acute, lasting less than three months, or chronic. Sometimes there may be recurrent flares in between periods with normal skin. The causes can be endogenous like (atopic), repeated pricking or rubbing, dyshidrosis (increased sweating), and idiopathic like hyperkeratotic hand eczema.

The exogenous causes are chemical contact with detergents, soaps, allergens, contact with irritants, food or drug allergies, infection (bacterial, fungal, or viral).

The differential diagnosis is tinea manuum and keratolysis exfoliativa. The risk factors are wetness, stress, high temperature, cold, dry air, low humidity, occlusion, atopy, and dry skin.

Kindly avoid the known allergens and irritants. And I suggest you apply Emollient Barrier creams (Hemp oil, Canola oil, Soybean oil, Omega acids) and Motium cream (Mometasone) at night for four weeks. And apply Mupirocin ointment in the daytime for 15 days. Wet dressing with Povidone-iodine is needed.

Avoid excessive sweating, stress, dry conditions, and minimize frequent hand washing as it triggers eczema.

Does he have a fever or any fluid oozing from the site?

Kindly revert.

Thanks.


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