Date: 11/03/2021

Q: Looking for thoughts, my almost 3 year old with congenital ichthyosis has an awful rash on her private area. She is potty trained but still uses a pull up at night. The rash is literally in the shape/outline of a diaper. l’ve taken her to her pediatrician twice in two weeks and they just are stumped or thinking it’s just dermatitis telling me to try different creams. Our derm is two hours away and haven’t been in over a year but I think we’re going to have to get worked in because there’s no relief for her. It’s red and bumpy and now it’s even moving up her chest. She’s scratching like crazy, she tells me it hurts and it flares up more at night. We’re doing Benadryl at night to help her sleep. She was just sick with some type of cold but we were not prescribed any antibiotics, so no chance it could have been reaction to that. No changes in soaps, laundry detergent, or her lotion routine. I’m wracking my brain on what caused this and what to do? She’s miserable! Does this sound familiar to anyone? Or do you have any suggestions? Thanks in advance.

A:

• Did it start with a new box/pkg of pull ups? This is what my daughter looked like with an allergic reaction to all disposable diapers. When her second one spread (didn't start in her diaper area) it was diagnosed as an egg white allergy.
• We did grab a different brand of pull ups and then immediately switched back to the old brand, thinking it could be the cause, but it’s only gotten worse.
• Honestly it looks like an allergic reaction
• I was wondering this too. I’m wondering if we need to get her allergy tested.
• My daughter got that rash all the time a baby. I believe it's just dermititis from the constant friction from the pull up. After diapers she never got it again.
• My kiddo with CIE looked like this until he was out of all diapers. We actually used a bed wetting alarm to night train him. He was day trained less than a year and a half old and it was the best decision for him. He was so much more comfortable and the alarm was something he wanted to do. It didn’t take long at all.
• We never had this rash with diapers though! She’s been potty trained during the days for almost five months now, so this is just out of no where!
• Could be a rash or yeast. Have you had it scraped at the doctor?
• Her pediatrician’s office didn’t seem concerned that it was yeast. And we’ve seen two different physicians within the office in the last two weeks! I may have to call again tomorrow ??
• I’d see your dermatologist and insist on a scraping.
• The first few times my kiddo had yeast they didn’t think it was until the scraping because it looked different on his skin. They even tested him for diabetes as a toddler because they said so many yeast infections were really rare. Now that he’s a teenager he can spot them earlier and usually can knock them out with OTC products.
• I put in a message to them. Who knows when they’ll get us in.??
• I guess we are lucky to be near a university hospital who will get us in ASAP if there is an emergency like this. They have a note in his file to work us in- they know we rarely use it
• What does the yeast look like for them? She does have one spot high up on her neck that looks like it has a white head.
• It typically starts with red bumps, often pimpley looking. My kiddo often had cracks between the toes when his diaper area looked like that too. Anywhere that flexes are his ‘hot spots’ for yeast
• They may want to swab it to check for bacteria too. Another thing is our kids can have eczema in addition to ichthyosis.
• I suggest antifungal foot powder. When my kiddo was little and we still use it! Zeasorb AF is our favorite. There are several topical creams we like too. If it’s yeast and it’s that widespread, we always needed oral meds though.
• Try some Triple paste AF. Our dermatologist recommended it for rashes.
• We have ??
• Aww poor baby ?? Hope you find something that works
• Swap pull ups. My son was highly reactive to Pampers. As soon as you put a Pamper on him, he would break out into a rash just like that within 30 minutes and would stay on for days. After we switched to Huggies. Huggies never have caused him anything. My son has LI.
• We have always have used Huggies diapers when she was in diapers and then recently tried their overnight pull ups and the rash started shortly after. So, we immediately switched back to Huggies overnight diapers we had been using instead of the overnight Huggies pull ups. No relief.
• How long has it been since you switched? Seems like it took almost a week for it to go away. We try to stay pretty simple and consistent with our son. Aquaphor severely dry skin, Triple Paste, and Huggies haha. I would try a thin coat of Triple Paste and see if it helps relieve the itching. Assuming the spreading bumps is from scratching.
• It’s been about two weeks since I switched. I immediately switched when the rash started. Your routine sounds like ours. We even did try the Triple Paste already, Aquaphor is what she asks for so it provides some relief for her.
• Was it tested for yeast?
• No testing was done on it at all!
• It looks like yeast, my daughter got it all the time and it spreads up the body. It is very itchy and painful too. She has a standing prescription from her Dr. for Nystatin ointment which works well for flare ups. If it gets too out of control then I’ll take her to the Dr. to get oral medicine. It’s worth asking your Dr. about.
• We had the same thing over the last two weeks with our almost 3 yr old who has LI. We used Nystatin cream for two weeks then had to be on oral Diflucan as well. It looked exactly the same as your picture. We are 3 hours away from our dermatologist. They allow us to send pictures to them and will give our pediatrician recommendations. There is also an option on the FIRST website for your pediatrician to talk with experts if they are stumped. Maybe ask if your pediatrician is willing to use that.
• Any chance it’s hand foot and mouth?
• We just had that a couple of months ago actually, so it doesn’t look similar to that when she had that.
• Try Lotrimin cream
• My kiddo gets that way and we have to switch brands of pull ups.
• We went back to overnight diapers instead of the pull-ups to see if that helped any
• We even had to rotate cloth pull ups.
• Yes. Rinsing with cool water and going without pull ups as often as we could helped my son but it was challenging.
• We only try to do pull ups at night because she hasn’t mastered overnight yet! But maybe it’s time.
• Heat rash?
• This crosses my mind too, but do heat rashes stick around for weeks at a time?
• While in the NICU our girl had a heat rash because all they were using was Vaseline— it took quite a few days, but I don’t think weeks. ??
• Our daughter also gets a rash and then peels any time she gets any kind of viral illness.
• We did just have a bug of some sort, so I was thinking that too because the edges of the rash are peeling some. But the spots spreading up her chest are odd to me.
• My 2 year old with EI gets red/irritated around the same area with his pullup, especially at end of evening. His is the friction. I slather tons of Aquaphor to try and protect from the friction of the pullup. It looks like a reaction from the pullup. Did u change brands? Maybe try a different brand. She could be reacting to something in the pullup.
• We did change and when she first showed signs of a rash I switched right back to the old brand. She’s in cotton underwear during the day and it’s right after her evening bath it flares up and she says it hurts before we even get the pull up on.
• Aww poor girl. Maybe don’t do the pullup for a few nights? May be a mess in the morning, pad the bed with layers of towels and let her sleep in her panties to give her skin a break and fully heal. Maybe the different brand messed her skin up and it doesn’t have a chance to breathe and heal and then its pullup time again and it’s a cycle.
• I would suggest getting a swab ASAP then you know what you are dealing with! My daughter had a similar rash that was staph and needed IV antibiotics.
• Oh my! I am probably calling the pediatrician again tomorrow and I also put in a note to her dermatologist!
• Don’t panic! For us she had the rash for months before I finally insisted on a swab and it’s was staph like I thought and the derm had been saying it wasn’t! That’s why a swab is great as at least it usually gives you a proper answer rather than a guess!
• Looks like the yeast my son with CIE had in his diaper area. Clotrimazole helped.
• Looks like yeast to me too. My youngest son (1 y/o) has had two bad cases. I've used vaginal yeast infection cream and that helped treat it.
• Awe my son use to get like this. We used Corona, not sure if you have ever seen that but it's for cow udders. It's the only thing that ever worked. Occasionally the doc would give him a Nystatin cream but it usually never worked. Let her run around with a dress or just some comfy shorts without pull up or switch to panties while she is home. The less she is in a pull up the better it will get. In our experience anyway.
• She’s always in panties during the day! Just uses the pull up for night time
• By any chance what kinda of pull up is it?
• Huggies brand of night time pull ups and then we always used Huggies overnight diapers. I immediately switched back to the diapers once the rash arrived.
• So this happened with my daughter, and someone sent me an article that some of the Huggies have recalls for chemical burn diaper rashes and that’s exactly what Caleigh’s looked like. I’ll pm you pictures.
• Looks like yeast to me. I say try Lotrimin. The yellow label Lotrimin worked best for us vs the Orange label
• You could do cloth diaper pull ups! We’ve never gotten rashes while using cloth.
• We got a nasty rash in the area with my newborn. We switched diaper types (not even the brand, a different type from the same brand), and we think that was the culprit. We switched back to the regular diapers, used just wet soft cloth as wipes, and applied Bactroban twice a day and it went away in just a few days, thankfully, it was really red and spreading initially.
• I hope you figure it out!!
• Hi, I am adult with EI but I am also paralyzed from a massive stroke I had a few years ago and also have OAB so I do use the adult pull up briefs and I get a very similar rash as did my kids when they wore pull ups and diapers we used uncle Mike's butt paste ?? which you can Google search and buy online.
• Calmoseptine
• Does your derm let you take pics and email them. Our daughter gets that often. We use hydrocortisone cream and Aquaphor as a barrier. But you may need an antibiotic. We also use a combination of two creams when it is directly on her privates.
• Looks like a yeast infection...have you tried Nystatin?
• Yeast or any change in her diet... sometimes when my son eats something he can’t tolerate and it’s in his pee all night... rash
• I wouldn't use the same pull ups anymore. My unaffected daughter got chemical burn from the back of a dry diaper. Very painful and diaper cream made it worse. She went nude for a while.
• The brand that we tried on my son and he has really little redness is Parent's Choice (Walmart) Also for the redness we're using Sudocream on and it has been helping so much for oozing or rash.
• We had a very similar thing happen to our baby girl, she had it on her sides. It turned out her diaper was getting a bit too small. We used Sudocream to heal the areas and a bigger pull up diaper did the trick, since it's a bit more loose.
• My son gets that occasionally they think it’s irritation from his diaper or clothes.
• We recently had something similar and stopped dairy and it helped tremendously!
• Try changing the brand of pull ups. My son could ONLY use Huggies diapers. Everything else made him break out in this kind of rash.
• I suggest the cotton training panties. I had to use cloth diaper long ago with both of my kids. Even if they only had a Pamper on for a family visit, they looked like this. Poor baby! My daughter only had 1 accident after going into panties, and she didn't like that, so she was totally trained at that point! I guess they still make the thick cotton panties? I hope?! Good luck Mama??
• Crazy as it sounds, I used unsweetened yogurt. I read about women using “yogurt popsicles” to naturally cure yeast infections. I would dump it in his diaper and leave it for about an hour then bathe him. He’d run around naked for a bit to ensure he was super died off before putting diaper back on.
• Could she have developed an allergy to the pull ups? Seems odd, just a thought.
• While normally I'd think this is yeast, it looks more like contact dermatitis that's gotten worse from continued exposure. My 5-year-old recently got this when my husband put a new outfit on him that he got for his birthday, before I washed it. Everywhere the new outfit touched, he looked like your daughter's diaper area and it looked very similar to a yeast rash. I would suggest no longer using that particular pack of pull ups and use a different brand at least for now - sometimes a particular lot of them has some type of contaminant or the formula they use in the materials is 'off' and it can cause contact dermatitis (this happened several years ago with Huggies and another off brand that made many kids get chemical burns). If you haven't tried the New Leaf ones from Pull Ups the material is softer and seemed less irritating and it may be a more comfortable option while she heals. I used a mix of coconut oil and shea butter on my son's skin when he got dermatitis and just watched for signs of cellulitis.
• Is it a yeast infection? Have you tried over the counter treatments for that?