Seborrheic Dermatitis
Causes and Distribution: Seborrheic dermatitis may be one of the most common and earliest skin conditions in newborn babies. After birth, babies’ sebaceous glands are relatively developed, causing them to secrete more oil. This often leads to the appearance of thick yellow-black greasy scales in areas with more sebum production like the scalp, face, and skin folds. Seborrheic dermatitis usually appears early but may gradually subside around 4-5 months of age.
Improvement Methods: If the yellow discharge caused by seborrheic dermatitis on the scalp is excessive, parents can use a cloth soaked in baby oil or vegetable oil to massage the baby’s head before each bath. This helps dissolve the thick sebum secretions, which can then be washed away during the bath. Continuing this process for some time should gradually improve the symptoms.
Treatment: If seborrheic dermatitis spreads to other sebum-rich areas like the scalp, eyebrows, sides of the nose, lips, ears, and behind the ears, causing local redness, topical corticosteroid ointments can be used for treatment and should restore normal conditions within a short period.
Fact About Allergies
How to distinguish seborrheic dermatitis from atopic dermatitis? Sometimes it’s difficult to distinguish seborrheic dermatitis from atopic dermatitis, and they may even overlap. In such cases, since both conditions are a form of eczema, ointments used to treat eczema or atopic dermatitis can help alleviate the symptoms.
Drool Rash
Causes and Distribution: Babies tend to drool after birth, which can cause a rash around the mouth known as drool rash. This type of rash is more likely to appear around the mouth, but for babies who drool while sleeping on their back, the rash may extend to the neck or areas in contact with the pillow.
Improvement Methods:
Drool rash can improve by frequently wiping and keeping the affected area dry, or as the baby gets older and drools less.
Treatment: In severe cases, astringents like zinc oxide or low-concentration topical corticosteroid ointments can be used to improve the skin condition.
Fact About Allergies
How to distinguish drool rash from atopic dermatitis? Drool rash is usually limited to the area around the lips and can improve by keeping it dry, whereas atopic dermatitis has a wider range covering the cheeks, behind the ears, and neck. Its rash also appears as one large patch with slightly raised edges. If unsure, it’s best to have a specialist examine it.
Prickly Heat and Eczema
Causes and Distribution: In summer or humid conditions, many children easily sweat in areas like the neck and creases of the limbs, causing prickly heat rashes which can develop into eczema when severe. Since folds also occur at the neck and limb joints, it may be difficult to distinguish from atopic dermatitis. Similarly, if a child already has atopic dermatitis in those areas, excessive sweating can aggravate the condition.
Improvement Methods: To prevent prickly heat from worsening atopic dermatitis symptoms, attention should be paid to the baby’s living environment.
Treatment: Whether treating sweat-induced eczema or atopic dermatitis, topical corticosteroids can provide improvement. However, parents may be reluctant to use corticosteroids for prickly heat and can first try prickly heat powders, anti-histamine ointments, and ensuring dryness after sweating.
Diaper Rash
Causes and Distribution: As the name suggests, diaper rash refers to skin rashes that appear during the diaper stage, caused by the baby’s skin coming into contact with urine and feces. Although most parents change diapers frequently, those bodily wastes can still cause skin reactions in a very short time.
Improvement Methods: Since diaper rash is essentially a form of contact dermatitis, keeping the skin dry is crucial for improvement. After changing diapers, thoroughly wipe and allow maximum air exposure.
Treatment: If symptoms are pronounced, astringents like zinc oxide or low-concentration topical corticosteroids can help soothe inflammation. However, diaper rash areas are prone to fungal infections, which can worsen symptoms and cause severe redness and swelling, requiring antifungal medication.
Urticaria
Causes and Distribution: Urticaria (hives) is one of the most common skin reactions to food allergies. When a baby consumes an allergen food, the body mounts an allergic response that manifests as raised, reddish rash patches of varying sizes on the skin. These patches start flat but swell when rubbed or scratched, rapidly expanding with intense itchiness. In severe cases, hives can spread all over the body. Acute urticaria is mostly triggered by food allergies, rarely by other illnesses.
Clinical Features:
A key characteristic of hives is that the rash patches appear and disappear rapidly and unpredictably, hence the colloquial term “wind rash”. This transient nature clearly distinguishes urticaria from other types of rashes.
Treatment: Most acute urticaria requires antihistamines and short-term, low-dose corticosteroids to control symptoms. Once the food allergen is eliminated, hives typically subside within a few days.
There is also a chronic form of urticaria with a prolonged course, often exacerbated by stress, hormonal changes, etc. Besides medication, lifestyle adjustments are important for managing chronic urticaria, now understood to involve an autoimmune mechanism rather than just an allergic reaction.
Fact About Allergies
Is the mechanism of chronic urticaria different from acute urticaria? Yes, the underlying mechanisms of chronic and acute urticaria differ. Acute urticaria follows a more typical allergic reaction pattern, while chronic urticaria likely involves an autoimmune component.
Recent research shows some chronic urticaria patients have autoantibodies against IgE receptors. These autoantibodies can activate mast cells releasing histamine to trigger hives. Other studies link chronic urticaria to Helicobacter pylori infection, with symptoms improving after eradicating the bacteria. This contrasts with the allergic basis of acute urticaria and suggests chronic urticaria has a more complex pathogenesis.
Erythema Multiforme
Causes and Distribution: Erythema multiforme is another concerning skin condition, typically associated with viral infections (e.g. herpes simplex), bacterial infections (e.g. mycoplasma), or adverse drug reactions – all involving an immune response. The characteristic lesions are symmetrically distributed red patches or raised papules, initially appearing as simple flat red marks that later develop a “target” or iris pattern. These lesions favor the extremities, trunk and face. Apart from the distinctive rash, severe cases may also present with systemic symptoms like fever and joint pains.
Improvement Methods: If erythema multiforme is suspected to be drug-induced, the offending medication should be stopped immediately.
Treatment: Moderate to severe erythema multiforme requires systemic treatment like oral corticosteroids or intravenous immunoglobulin to control disease progression. Topical antibiotics may also be needed to prevent secondary skin infections.
Tinea Corporis (Ringworm)
Causes and Distribution: Tinea corporis, commonly known as ringworm, is a superficial fungal skin infection. Taiwan’s subtropical climate provides a warm, humid environment conducive for the growth of these dermatophyte fungi. Ringworm lesions typically begin as small red patches that gradually enlarge into raised erythematous rings with central clearing. The active edges are scaly and raised, and vesicles or pustules may be present with significant itching. If the infection occurs on the feet, it is called tinea pedis or athlete’s foot. Ringworm can affect any area of the body.
Improvement Methods: Maintaining good hygiene and keeping the body clean and dry are essential for preventing ringworm infections. Wear loose, breathable cotton clothing and avoid excessive sweating. If someone in the household has ringworm, take extra precautions like separating laundry. Using air conditioning and fans to regulate humidity at home is also helpful.
Treatment: Confirming a ringworm diagnosis often requires microscopic examination of skin scrapings from the lesion to detect the characteristic branching fungal hyphae. However, this may not be conclusive in some cases, requiring clinical diagnosis by a physician. Once ringworm is confirmed, topical antifungal medication needs to be applied over an extended period for complete cure.
Fact About Allergies
How to treat ringworm superimposed on atopic dermatitis? Sometimes ringworm can coexist with atopic dermatitis in the same patient. The repeated scratching and topical medication use in atopic dermatitis can impair the skin barrier, making it more susceptible to fungal infections like ringworm. In such cases, in addition to the usual atopic dermatitis treatment, concomitant use of topical antifungal medication is required to manage both conditions.
Psoriasis
Causes and Distribution:
Psoriasis is a common but stubborn chronic skin disorder. Its exact cause remains unclear, but it is widely accepted as an immune-mediated disease. The most common type is plaque psoriasis, characterized by well-demarcated red plaques covered with silvery-white scales. Removing these scales often leads to pinpoint bleeding (Auspitz sign). Psoriatic plaques favor the scalp, extensor surfaces of limbs, and trunk, though at times it can be difficult to differentiate from other skin conditions like atopic dermatitis or ringworm.
Improvement Methods: Since psoriasis involves an underlying immune dysfunction, topical treatment alone has limited efficacy. Systemic immunomodulatory medications are the main therapeutic approach.
Treatment: Psoriasis treatment relies heavily on potent drugs like corticosteroids and other immunosuppressants aimed at reducing the overactive immune response that drives the skin changes.
Scabies
Causes and Distribution: Scabies is a distinctive skin condition caused by infestation with the microscopic Sarcoptes scabiei mite. These mites burrow into the uppermost layer of skin to live and lay eggs, triggering an allergic reaction that produces the characteristic itchy rash. Scabies lesions commonly appear in skin folds and creases prone to sweating, such as between fingers, wrists, axillae, groin folds etc. The intense itching is often worse at night. Scabies spreads rapidly through close personal contact, making intrafamilial transmission very common.
Improvement Methods: To prevent further transmission, all clothes, bedding and other fabric items used by the patient must be thoroughly decontaminated with hot water above 60°C.
Treatment: Treating scabies requires the application of special scabicidal ointments to eliminate the mites infesting the skin, as well as their eggs. In severe cases with widespread rash, systemic antihistamines may also be needed to control the allergic reaction and itching.
Folliculitis
Causes and Distribution: Patients with atopic dermatitis often cannot resist the urge to scratch, resulting in skin excoriations that compromise the protective barrier. These disrupted areas of skin then become susceptible to bacterial infections, which can manifest as folliculitis – inflammation of the hair follicles. Severe folliculitis may progress to more serious skin infections like cellulitis or facial plane abscesses. In rare cases, it can even lead to life-threatening systemic infections like sepsis.
Improvement Methods: Maintaining good personal hygiene is crucial for preventing folliculitis and other skin infections.
Treatment: Once folliculitis sets in, topical and systemic antibiotics are required to control the bacterial infection and prevent further complications.
In summary, while these various skin conditions commonly seen in infants may share some similarities in appearance, there are still subtle differences that require proper diagnosis and management. It is advisable to seek professional medical advice promptly if any abnormal skin changes are observed.
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