Pediatric rash ? unsure DX.

[Amy3878]

Dear Dr.,
I am a mom of a 8 year old girl who has been having redness and skin sloughing in the rectal area. She also has redness in the labial folds as well. We have been treating this with desitin and RX cream,it does clear up for alittle while but comes back. Her physician is not sure what it might be or the cause. I am just looking for any ideas as to the cause as she does state that it does become painful when using the restroom.

If you need any further information please let me know.
Amy

[Amy3878]

Thank you for the useful information. We are currently using a nystatin cream. No other signs or symptoms are present, other than her skin is cracked at the very front of her vaginal area and back of her rectal area, causeing them to bleed on occasion. I am skeptical to think that it is a detergent issue as I have changed occassionally and it still appears.
It does get better if we keep up with the creams.

[Dr Santos]

Hi,

This could be an infection, irritation or a type of dermatitis or eczema. Are there other signs or symptoms present? Fungal infection may need to be ruled out. Diagnosis is through evaluation of skin scrapings from the rash. This usually responds to anti-fiungal medication. Treatment usually depend s on the underlying cause.

It would also help if you shift your detergent or soap to a milder type and observe if the rash improves. This could be a type of irritant dermatitis.This usually resolves when the irritant is removed. A urinalysis may also rule out infection. It is important to keep the area clean and dry. Take care and keep us posted.