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Suggest treatment for rashes on the legs and arms in a child

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Posted on Fri, 27 Apr 2018
Question: this is regarding my 5month old son. since last Thursday he started having rashes over some of his body parts (legs and arms). by Sunday, it appeared over all of his body including his gentials. we took him to a pediatrician in Apollo on 20th, who recommended atarax drop and elosmooth lotion for 3 days. also mentioned that if continues, should show a dermatologist. while his old rashes were drying up, new were coming up. we took him to a dermatologist in Kims who mentioned that this is the case of atopic dermatitis and recommended Atogla lotion, tedibar soap and desowen 0.05% lotion. with continued use of atarax. attached are the prescription from both hospital along with some images of the rashes. our concern is primarily whether the diagnose is correct and for how much long should desowen be used (considering it's a steroid).
doctor
Answered by Dr. Kakkar S. (59 minutes later)
Brief Answer:
Treatment is fine. Continue for 2 weeks

Detailed Answer:
Thank you.
I am Dr. kakkar (Dermatologist and Venerelogist).
I have noted your concern and I have viewed the images.
I can see dry, red, bumps and patches on neck, back and groin folds. I would keep a possibility of Seborrheic dermatitis rather than Atopic Dermatitis. In infancy, Atopic Dermatitis is a close mimic of Seborrheic dermatitis.
The involvement of groin folds with dry, scaly patches is particularly characteristic of Seborrheic dermatitis rather than Atopic Dermatitis.
Is his scalp also involved ? with adherent greasy scales/ dandruff?
Seborrheic dermatitis too is managed on the same lines as Atopic Dermatitis i.e topical steroid cream and oral antihistamine.
I agree with the treatment plan and I suggest you to continue the same for 2 weeks.
Desowen cream is a very mild steroid (desonide 0.05%) and is safe for use in infants and children. It can be safely used for 3- 4 weeks or even longer if required

Regards

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Kakkar S. (11 hours later)
attached the scalp photo. he had very light craddle cap at the time of birth. this is since last 3 weeks. (the yellowish tint is turmeric)
doctor
Answered by Dr. Kakkar S. (53 minutes later)
Brief Answer:
Seborrheic Dermatitis

Detailed Answer:
Thank you.

That cradle cap is actually Seborrheic dermatitis on scalp. I think his skin involvement too is part of the same condition.
you may apply desonide cram even on the scalp, twice daily.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Kakkar S. (10 hours later)
thank u sir. only one more query and concern. is this something that might reoccur. is there any precautions that we can take?also, the redness have come on his face too, one near eye. is there any concerns? should we apply desonide there? he sometimes rubs his eyes and we worry that it might go in his eyes or mouth.
doctor
Answered by Dr. Kakkar S. (10 hours later)
Brief Answer:
Seborrheic dermatitis

Detailed Answer:
Thank you. I have viewed the images.

Seborrheic dermatitis can have a few relapses but ultimately it resolves with time..winters and cold weather may bring in a flare whereas summers and humid weather are usually good.
The red patches on upper eyelid and cheeks are also part of the same condition. You may use Desowen cream( desonide 0.05%) over these patches on face and upper eyelid. Use it once daily when he is sleeping so that he doesn't rub. I think these patches would be fine within a week or 10 days. Thereafter you may discontinue the steroid cream.
There are non- steroidal alternatives for Seborrheic dermatitis like pimecrolimus 1% cream and ketoconazole 2% cream but they are approved only for children older than 2 years.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. (29 hours later)
thank you Sir. we are continuing as per the recommendation and glad to say that there is improvement in the rashes. thank you again!.
doctor
Answered by Dr. Kakkar S. (3 hours later)
Brief Answer:
You are welcome

Detailed Answer:
Thank you for your feedback and thank you for writing to us.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Kakkar S.

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Suggest treatment for rashes on the legs and arms in a child

Brief Answer: Treatment is fine. Continue for 2 weeks Detailed Answer: Thank you. I am Dr. kakkar (Dermatologist and Venerelogist). I have noted your concern and I have viewed the images. I can see dry, red, bumps and patches on neck, back and groin folds. I would keep a possibility of Seborrheic dermatitis rather than Atopic Dermatitis. In infancy, Atopic Dermatitis is a close mimic of Seborrheic dermatitis. The involvement of groin folds with dry, scaly patches is particularly characteristic of Seborrheic dermatitis rather than Atopic Dermatitis. Is his scalp also involved ? with adherent greasy scales/ dandruff? Seborrheic dermatitis too is managed on the same lines as Atopic Dermatitis i.e topical steroid cream and oral antihistamine. I agree with the treatment plan and I suggest you to continue the same for 2 weeks. Desowen cream is a very mild steroid (desonide 0.05%) and is safe for use in infants and children. It can be safely used for 3- 4 weeks or even longer if required Regards