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Child having rash on groin, rectal area. No help with ointments. Cause, treatment?

My 4yr old son has had a rash on his groin and rectal area for 3 weeks now. It started with redness and a few spots and has developed into weeping raised and red larger areas at worst. Treatments so far have included Daktarin, Canestan, Baktroban and Lomexin creams but none seem to have stopped the rash. I have also used Bepanthen ointment to calm the skin when it starts to crack and weep - this seems to help that immediately but we cannot get rid of the rash. It seems to reduce and then all of a sudden flares up again - although I cannot pinpoint why. Dr is not sure if it is fungal or yeast ..... considering trying low potency topical steroid cream next. Any ideas what it is, what is causing it and what i can use to treat it effectively?
Asked On : Wed, 20 Feb 2013
Answers:  1 Views:  86
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Pediatrician 's  Response

Hope he is not on nappies anymore.

If he is off nappies, its more likely to be a fungal infection.
Though he was given 3 anti-fungal creams, if fungal infection is still suspected, a swab can be taken from that area and tested both for fungus and bacteria.
Depending on the result, he can be put on oral medications.

The local area has to be kept clean and dry.
Try to keep it open as much as possible. When needed a soft cotton underwear will do. No nappies should be used.
After stools, gently mop it off with wet tissue. Do not wipe it hard.
You may apply Zinc based barrier creams like Siloderm thrice a day for a week.
In the groin, instead of creams, you may apply canesten powder.

Its wise to rule out worm infestations that present with peri-anal itching and excoriations.
Mild steroids can be tried.
And oral zinc for about 2 to 3 weeks will help.

If nothing works, you must visit a dermatologist- who will guide you further.

Hope my answer helps you.
Wish your son good health.
Answered: Thu, 21 Feb 2013
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