Eczema in infant?

[booboohead]

My 9-month old daughter has redness and dryness on her cheeks, nose and chin, as well as many small pimples (with and without white centers) around her mouth, chin, and lower cheeks.  The redness on her cheeks seems to fade and increase periodically throughout the day, and is especially red after eating and by the evening.  There is no evidence at all, however, of any itchiness.

Her lower lip gets red and swollen in various locations after drinking from her bottle, and seems to be associated with her skin condition.  Again, however, she does not appear to have any discomfort.

Does this sound like eczema? A different kind of allergic reaction? She was breastfed for four months, but could not digest the milk properly, resulting in a lot of abdominal discomfort and sugar passing through.  The rash began in a mild form then.  She was switched onto Neocate elemental formula, and has grown nicely, but the rash has slowly continued worsening.  The formula appears to cause a lot of mucus, and she rubs her nose and eyes often after drinking.  She eats a good range of solid foods with no apparent problems.  This week I tried substituting juice for formula, and while the mucus and eye/nose symptoms disappeared, the skin rash got significantly worse.  

Skin ***** tests turned out negative for all commmon allergens.

I have been treating this like eczema.  I use a plant-based "unpetroleum" jelly on her skin that works ok.  I've also occasionally used a cream made of olive oil and honey, but this makes it worse.  Could a candida infection be involved?


Thanks.

[Alan Rockoff, MD]

I suspect that at least some of the symptoms you list (especially the redness and dryness) are indeed eczema.  The pimples are probably something else, perhaps from drooling and rubbing her face onto the sheets.  Most people with eczema do not have specific allergies to anything--the condition is primarily genetic.  This does not sound like yeast.

The best treatment for infantile eczema is the use of very mild cortisone products, such as that available over-the-counter (1%).  I suspect that you are reluctant to use steroids, though you really needn't be--chance are you'd only have to use it once in a while, and the body wouldn't even notice the difference compared tot the steroids already circulating in the bloodstream.  If not, mild moisturizers will help a little (the "dryness" is really inflammation, not dryness per se.)

What does your pediatrician think?

Best.

Dr. Rockoff

[ToniDlo]

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[chap8]

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