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Ask Dr.Hanish Babu, MD Your Own Question
Dr.Hanish Babu, MD
Dr.Hanish Babu, MD, Dermatologist
Category: Pediatrics
Satisfied Customers: 544
Experience:  MBBS; MD (Skin & STD)
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My 2 and 1/2 year old has rash on legs from hips to ankles.

Resolved Question:

My 2 and 1/2 year old has rash on legs from hips to ankles. It also appears on upper arms and from time to time on his cheeks near his ears. He has lately begun to scratch and tell us that its itching. Since infancy he has had chronic diarrhea, we have been told that its nonspecific chronic diarrhea. He has had tons of testing and is not in daycare. Other than that, he has no known health problems. The rash is red skin with little hard pimple like bumps that once in a while get red and large with white and clear fluid in them. Is this eczema and will he have to live with this forever? I hate to think he will always have this hideous skin problem. Also, we have tried creams. Hydrocortizone seems to make it better, although it never fully goes away
Submitted: 7 years ago.
Category: Pediatrics
Expert:  Dr.Hanish Babu, MD replied 7 years ago.

Hello,

 

It seems that your son has Atopic dermatitis or Atopic eczema.

Atopic dermatitis is a chronic,intensely pruritic(itchy) skin disease that affects genetically predisposed infants usually with a family history of atopic diathesis.

It has onset age of 3-6 months in infancy and has varied signs and symptoms as it passes through infantile, childhood and adult phases. It runs a chronic course of intermittent attacks of itching and excoriations .

How long will the atopic dermatitis last? It is not easy to answer that question for any given child, but here is a common estimate:

  • 20 % of cases become free of the disease by the age of 4-6 years
  • 20% become symptom free by the age of 8-10 years
  • 20% stop getting recurrences at the age of 12-14 years
  • 20% get relieved of their disease by the age of 21 years
  • Unfortunately, the remaining 20% suffer throughout life.

Here are a few tips on dealing with Atopic Eczema:

  • Always keep the skin moist and supple with regular use of emollient cream applications immediately after washing
  • Do not use abrasive soaps
  • Avoid irritating food habits: spicy, hot, fried food should be avoided
  • Avoid chocolates, icecream etc
  • Keep a diary with columns for food taken, time, activities, grade of itching and the peak and low periods of itching etc. Such diaries are excellent ways to find out and eliminate any aggravating food or activities.
  • Give an antihistamine to relieve itching , like benadryl.
  • Use only cotton clothes
  • Avoid contact with dust and chemicals
  • Treat any flare ups immediately with the help of a dermatologist. He will prescribe topical steroids of varied strengths depending upon the severity of the allergy and the sites. Steroid sparing medications like tacrolimus and pimecrolimus can also be used to reduce recurrences. Special care should be taken to treat any secondary infections.

 

If you need further clarification, please ask. __________________________________

My answer is for your personal information only. It should not be used as a substitute to visiting your doctor. No treatment should be tried without first consulting a doctor in person.

Customer: replied 7 years ago.
Well, it just doesn't look like any pictures I have seen online of atopic dermatitis. Its not on his knees and elbows. Its on his thighs and calves. Its not scaly and doesn't appear to resemble any pictures I have seen online. Is there anything else it could be? Is it worth our time and his discomfort to look into allergy testing?
Expert:  Dr.Hanish Babu, MD replied 7 years ago.

Atopic dermatitis or childhood eczema has varied presentations and there are lots of individual variations. Before doing allergy testing, do the assessment at home as outlined above.

 

The other diagnosis to be considered are: allergic contact dermatitis and asteatotic eczema due to dry skin. All of these have the same treatment approach as described above.

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