Case history
Case history
An 8-month-old girl presents with mild erythema of the labia majora, perianal area, and convex surfaces of buttocks for the past 2 days following a 3-day history of diarrhoea.
Other presentations
Other presentations include cases where nappy rash lasts longer than 3 days, cases that have accompanying worrisome signs or symptoms (i.e., child with faltering growth, recurrent infections), or rash that persists despite recommended treatments. Nappy rashes that last longer than 3 days are suspicious for secondary candidal infection and secondary bacterial infection (i.e., Staphylococcus aureus).[1]
Red, moist erosions in the nappy area accompanied by peri-oral or extremity involvement may signal acrodermatitis enteropathica. Scaly papules on face, scalp, and axilla may be secondary to histiocytosis. Nutritional deficiencies (zinc, biotin, essential fatty acids, protein), metabolic disorders (i.e., organic acidurias), or immune deficiencies may also be the cause of recalcitrant cases. A child who is neglected and/or abused and whose carer is non-compliant with treatment may present with consistently poor hygiene, bruises, or other suspicious skin findings.
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