Rashes that look like eczema

[endoftether82]

Dd 29 months had a little bit of eczema as a newborn, it cleared up pretty quickly. She's had a couple of dry patches since but it's nothing really.

5 days her whole torso has exploded with a sandpaper like rash, with round discs of angry red skin aswell. It looks terrible, it's all over her belly, back and arms with the odd patch on her legs. She says it itches, but there's no fever or any other symptoms.

The gp said it could be fungal, but nothing I've googled has come up with anything.

Does anyone have any experience of similar?

Sorry that's meant to say 5 days ago, typing on the phone!

It’d be useful for you to post a picture, but from your description the thing to exclude would be guttate psoriasis which usually presents as a sudden widespread rash over the torso consisting of round elevated lesions with silvery scales (itchy in some cases).

In children it’s usually provoked by a recent streptococcal throat infection (these can often resolve without treatment before the onset of the rash, so have a think about if she’s has a recent sore throat infection). The other thing that would increase the chances of this would be any family history of psoriasis.

Fungal rashes would almost never be so widespread, so I think it’s very unlikely to be that.

Hmmm will have a think. She was running a high temperature about a month ago but I think we thought that was teething. There was a chance it could have been a throat infection though as I think I remember her breath smelling.

She's just gone to sleep so will try and post a picture tomorrow.

The gp said to treat as both eczema and fungal, which we've been doing for the last couple of days, but it seems to be getting worse.

Having just looked at guttate psoriasis, I don't think it's that. The disks are bigger patches and don't have the silvery too to them. I could be wrong obviously.

Post a pic, it’d be helpful. Otherwise we’re just speculating.

Will do tomorrow, thanks so much jean

Here are some photos. Like I said this suddenly appeared, no real signs of eczema before apart from as a newborn and a couple of dry patches since.

Yes that's eczema. My dd has been covered in it since she was 2 months old. I would get to the doctors to get something to treat it before it starts to spread. My dds started like this and we were fobbed off a few times saying it was nothing and not given cream for the first month. And now it sgows no sign of leaving 5 month on

That looks like a eczema flare up to me.

That looks like eczema to me. My DS flares up like this every April as soon as the pollen counts start to rise. He is an itchy mess until October.

Oh no, I was hoping it would be something that would go away in a week or two. So what's the best approach? I've been putting very small amounts of hydrocortisone on, folllowed by slathering I'm epiderm. Is that the best tactic?

Yes the hydrocortisone is good but only once a day. The other cream will depend on your baby. Everyone is different. We had epiderm, oilatum, sudocrem and diprobase. Diprobase is the only thing working for us.
We bought into the hype of child farm moisturizer being good for eczma. Everyone swears by it. But it made my dds flare ups even worse.

It's so hard because it's a bit trial and error with your own. We has some hits and misses with prescribed emollients and eventually found that aveeno from the supermarket revolutionised our world! But as others will say, it doesn't work for everyone. Our key is keeping hydrated at all times and after every bath and shower to moisturise really well. It has to be a habit. We find if we are slack on the moisturising then we get a flare up.
Definitely worse between April and Sept!

Discoid eczema

Very useful these pics. It’s definitely eczema, and it definitely isn’t infected eczema (either bacterial or fungal).

Needs to be treated with emollient (paraffin based - diprobase/zerobase/epaderm etc) plus a steroid cream. As it isn’t infected, antifungal or antibiotic creams won’t be of much use.

If a low strength of steroid cream doesn’t work, you proceed up the steroid ladder going gradually from weaker to stronger preparations until you find a strength which does.

And once the eczema resolves you need to continue with the emollient twice daily to prevent recurrence.

Most children will grow out of it, a small proportion will end up having it into adulthood - whether your child ends up in this group will be largely dependent of if there’s any strong family history of the atopic conditions (asthma, eczema, allergic rhinitis).

Have a think about what may be provoking it (generally the culprit will be either dairy or washing powders or various shampoos/soaps/shower gels).

Ps you need to use the creams in a very definite way otherwise they don’t work as well.

Apply the emollient first, slather it on and give it a few hours to sink in.

Then apply the steroid (emollient first increases the absorption of the steroid cream). Unlike the emollient don’t slather the steroid on - for best results you need to use one fingertip’s worth to cover a palm’s worth of skin surface area.

Repeat twice daily.

This is all amazingly helpful, thank you so much. How long do you think it's worth trying each emollient for?

If you don't want to use steroids on an ongoing basis (I have a 6mo who has been on various steroids for eczema since birth), then I have found that if I wash him in Aveeno gentle wash with barley and use Child's Farm moisturiser, it has cleared it as well as steroids!

We were told to to give them a week each before deciding if they make a difference

Find one emollient and stick to it unless it isn’t preventing recurrences after the acute flare has settled. The actual treatment of the eczema lesions/acute flare will be down to the steroid cream which you should use in 2 week courses before upgrading to a stronger strength if the current strength isn’t working.

I have a similar aged toddler with periodic eczema and personally use regular epaderm which I buy over the counter alongside either hydrocortisone or betnovate which works very well.

I like the epaderm because it’s an easy consistency for regular application and comes in a handy pump action bottle. But I can’t prescribe it to my patients because of NHS/CCG guidelines instructing cheaper alternatives as the epaderm is expensive - to be honest the cheaper diprobase/zerobase your GP may prescribe will probably work just as well. Any of the emollients will do. Just pick one and stick to it.

You shouldn't use hydrocortisone on face or for more than 7 days as it thins the skin on adults, not to be used on kids. hopefully what you are using was prescribed for her.

I used a prescribed emollient Oilatum and it actually made it worse. And also another prescribed cream that also made it worse. Sometimes it is a combination of prescribed creams and what works for your skin.
For itching take antihistamine tablets :) You can also buy cotton gloves from Boots which you can give your daughter to wear if it does get worse or become a regular health condition.

Also maybe check she is not allergic to any shampoos, soaps, creams etc you may be using on her

if anyone has it on their scalp Neutragena T Gel shampoo is great to use and seems to be always recommended It stinks a bit but your scalp feels so much better