Monday, January 5, 2009

Rashes can be fun...

I love rashes…well…as a physician, not as a parent. I’d say that a good 5% of all my visits are for some form of a rash; from diaper rash to acne. Rashes are often benign, but very rarely can be life threatening. I’ve decided today begin covering some commonly seen rashes from the newborn period to twelve months of life. For each diagnosis (not everyone) I’ve provided a link to Please consult your physician for any questions regarding your child’s rash (this is for informational purposes only).

My favorite newborn rash is erythema toxicum. This is seen from as early as a few hours after birth, and it typically goes away within 1-2 weeks. This is a very common rash and is harmless. It can often look very fearsome and cover the entire torso…but again it’s very harmless. Typically it consists of yellowish papules with a red base and often is displayed in areas that are in constant contact with clothing or a diaper. This rash does not affect the palms or soles.

Acrocyanosis is also commonly seen in the newborn period; however, it isn’t really a rash. This is when the hands and feet have a bluish discoloration and the remainder of the body is healthy pink. Again, this is benign but only in the newborn period. This is from vasospasm of the small vessels in the hands and feet and will correct on its own, usually before leaving home from the hospital.

Acne neonatorum (neonatal acne) often is distressing to parents and it always seems to pop-up right before family pictures. Don’t worry…it will go away and it won’t cause scaring. Typically it presents at 2-4 weeks of age and usually resolves by 4-6 months of age. Be careful with lotions and creams, as these can often make them worse. If you do apply a lotion, try and use a very gentle lotion (without dyes or fragrances) such as eucerin or cetaphil.

Eczema comes in various shapes and sizes and it can really be a time consuming rash. It’s a form of dermatitis and it requires constant lubrication with lotions, and at times will need steroid creams for severe flairs. It is often referred to as the “itch that rashes,” …in other words…it is dry skin that itches and after one scratches, it forms a rash. Again, it comes it many shapes and forms, but typically it is a rough, raised and erythematous (red) patch. Its location is dependent on age. In newborn and infants, it is often seen on the cheeks and torso.

I see plenty of diaper rashes, and it too comes in various forms; from contact to fungal. Most commonly it forms secondary to the moist environment that has developed in your loved ones diaper, and a simple barrier cream will do the job. But occasionally a fungal infection can develop. If fungus is among us then the rash consists of red “satellite” lesions (little red bumps) that surround a red inflamed rash in the diaper region.

Well…that’s all for now. I’ll continue my fun with rashes later.

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