Chapter 103 Diaper Rash and Other Infant Dermatitis
Clinical Case Problem 1: A 2-Month-Old Infant with a Rash on His Cheeks
On examination, the child appears healthy. He has an erythematous maculopapular eruption that covers his cheeks, and he appears to be developing an erythematous rash on his neck, both wrists, and both hands (Fig. 103-1). The rest of the physical examination is within normal limits.
Figure 103-1 A 2-month-old infant with an erythematous maculopapular eruption covering his cheeks. See Color Plate 1.
(Reproduced from Habif TB: Clinical Dermatology, 4th ed. St. Louis, 2004, Mosby, with permission.)
Select the best answer to the following questions
1. What is the most likely cause of this infant’s rash?
2. What is (are) the recommended initial treatment(s) of the rash in the infant presented?
3. Which of the following is not routinely associated with this condition?
4. Which statement is false regarding the prognosis and treatment of this condition?
5. Which statement is not true regarding the etiology of this condition?
Clinical Case Problem 2: A 3-Week-Old Infant with a Crusty Head
A grandmother brings in a 3-week-old infant with the complaint that she has “crusting” on her hair. Because it has been quite cold, the grandmother (who cares for the child) has been careful not to bathe the child too often, and she does not use shampoo. The child is bottle-feeding and has otherwise had no health problems. On examination, the infant appears healthy and interactive. Her scalp is covered with a crusty, yellowish rash with some erythema and crusting at the base of the ears and scalp (Fig. 103-2).
6. The most likely diagnosis of this rash is
7. Recommended treatment of the rash initially is
Clinical Case Problem 3: A 2-Week-Old Infant Who Looks “Too Ugly for Photos”
A 2-week-old infant, a product of a normal birth and delivery, is brought to your office by his mother, who says she cannot take baby photos because his skin “won’t clear up.” According to the mother, ever since birth, the child has had small pimple-like lesions on his face and scattered over his body that come and go (Fig. 103-3). They sometimes get slightly erythematous, but they are not crusty. The baby is not bothered by them, but his face looks “so ugly” that his mother does not want to have his photo taken. She wants medicine to “get rid of it.”
8. What is the most likely diagnosis in this infant?
9. What is (are) the treatment(s) of choice for the condition described here?
Clinical Case Problem 4: An 8-Month-Old Infant with a Long-term Persistent Diaper Rash
On examination, the infant has an intensely erythematous diaper dermatitis that has a scalloped border and a sharply demarcated edge. Numerous satellite lesions are present on the lower abdomen and thighs (Fig. 103-4).
