Monday, December 12, 2011

Medical Mystery Monday

Unlike fun alliterative themes like Wordless Wednesday or Foodie Friday hosted on other blogs, I hope this one does not become a weekly feature.

About a month ago, I noticed Peter's diaper rash was not healing. Or rather, was not behaving like diaper rash. The mild reddish rash had become three concentrated sores, two on his bottom and one on his scrotum. They were well-defined and raw, but didn't seem to bother him at all. They would start to heal, then the dead skin would come off in the bath or when being wiped and the sore was still open underneath. This continued for two weeks, so I decided to take him to the pediatrician's office.

Of course the day we saw the nurse practitioner, the sores were in their "healed" phase, so she didn't see the same thing I had been seeing. She prescribed a topical antibiotic to use for seven to ten days and encouraged us to use diaper cream as well to keep the area clean. After a week, there was absolutely zero change. We might as well not have been doing anything.

We went back to the doctor and this time received a prescription for an oral antibiotic that targets skin diseases, plus instructions to continue the antibiotic cream and diaper cream. My poor little boy. Despite our best efforts to convince him that medicine time was fun time, he cried at each dosage, twice a day for ten days. The results? The sores stabilized. They stopped cycling between "healed" and raw and became persistent red bumps. The two on his bottom also developed twins, parallel bumps on the other cheek.

I also gave him a lot of probiotic yogurt.

This morning was his last dose of oral antibiotics. After my husband went to work, I changed Peter's diaper and found his scrotum almost covered with sores. Again, they didn't seem to bother him at all, but this was too much for a mommy to ignore. We got an afternoon appointment with our pediatrician.

She was perplexed. She referred him to a dermatologist and we were thankful to get an appointment almost immediately. The dermatologist confirmed our ped's opinion that it was not fungal or yeast. He thought it unlikely to be bacterial, since it did not respond to antibiotics. (As an aside, I'm very pleased that no one has try to suggest this has anything to do with Peter being intact.)

He has prescribed a different cream, targeted to reduce inflammation. He hopes that treating the symptoms will allow the skin to soothe and heal itself. He advised not to use any diaper cream. So now we'll try this for a couple weeks and see what happens. While we're home, I'm using prefolds with no cover so I can change him immediately each time he wets.*

The crazy thing is that no one knows what this is. There are no other symptoms of infection and it is definitely confined to the diaper area. (The dermatologist was favorably impressed that we just use warm water to clean between changes. Yay!) I hope this new prescription works.


*This may also be a good prep for toilet training, which I want to start soon. Even I am not crazy enough to try to start that right before Christmas, though!

7 comments:

  1. Oh, I hope it gets better soon! It is amazing how they never seem to be bothered by things that seem like they would be so horrible.

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  2. Thank you! Yeah, his apparent ignorance of the entire ordeal is definitely a high point in this whole thing.

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  3. Sad to learn of this problem. Had you changed laundry soap when this first popped up? My long range input - rinse the prefolds twice when laundering. Could be a reaction to whatever laundry soap you are using.

    Aunt Monica

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  4. That must be scary - to have this and no one knows what it is. I'm so glad it's not bothering him - that would just make it all the more terrible. The next time you see the dermatologist (if he's not getting better), ask about applying raw honey to the rash. Though I haven't used it for a diaper rash, I have used it for other rashes and it really works well to a) kill the germs already there and b) prevent new germs from moving in. I know it sounds weird to be putting honey on your little one's bottom, but it really is one of those all-around healing agents!

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  5. have you introduced anything new to his diet before this started to happen? i have a friend, who after a long ordeal with severe diaper rash on her youngest son, discovered that he was allergic to milk. they originally thought it was a reaction to disposable diapers so i encouraged her to try cloth. that seemed to help some, but the rash seemed to still pop up, and fairly often. i'm not exactly sure how they came to the conclusion that it was dairy, but once they removed ALL dairy from his diet the rash disappeared. however, it comes right back if he eats anything that contains dairy - one goldfish cracker is enough to bring it back!
    i hope and pray that this will clear up and i'm glad that peter seems to be oblivious to what is going on! it is always heartbreaking to deal with a diaper rash and hear the cries from your child as you clean them up because you know you are doing what is best, even though it seems to hurt them.

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  6. Wow, 17 months is a good run, and above average! I got my cycle back at 9 months, but it was haywire for so long I still couldn't get pregnant. Seemed the worst of all possible worlds!

    As far as the rash goes, I second the allergy idea. Sometimes allergies crop up even from things kids are used to, because you eat them more than before or because something else has changed. My son had wretched diarrhea and a rash just like you describe (only sometimes with blisters) and it was eliminating gluten that made the difference. At least, I think it was the gluten ... we did make some other changes as well so I'm still a little unsure! It would certainly be worth keeping a food journal and trying to have a few days without each of his most commonly eaten foods.

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  7. Aunt Monica: We didn't change detergents, but I'll try adding an extra rinse anyway to see if that helps. Thanks!

    Alicia: We have a follow-up appt in early January, so if there is no improvement, I'll bring that up. Thanks for the suggestion!

    Donna: We haven't introduced anything new, but it's certainly possible... if this most recent prescription doesn't work, I might try eliminating common allergens and see if that changes anything. Thanks for the advice!

    Sheila: Every time I type your name, I start shi and have to fix it. You'd think I'd learn. Sigh.
    Yeah, my mom went about 18 months with all three of us, so I had reason to hope. Even 9 is not too shabby, though!
    Peter does have a bad reaction to oatmeal or Cheerios (diarrhea and bad diaper rash) so a gluten allergy is possible, but this rash doesn't seem to fluctuate based on what we eat and isn't focused around the anus. If we get to the new year with no improvement, I will be more diligent about tracking what we eat and any side effects. Thanks for sharing your idea!

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