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Abstract: Recently, because the parents changed the child’s diaper to a brand, and then found that the child had a significant rash on the skin near the anus and localized redness and swelling of the skin around the anus, but it was limited to this one area, and the skin on other parts of the body was fine, and the child was considered to have perianal eczema after consultation. The child’s symptoms were relieved by the administration of ointment.
Basic information】Female, 3 months old
Type of disease】Perianal eczema
Hospital】Shanghai Sixth People’s Hospital
Date of Consultation】January 2022
Treatment plan】Change diaper + medication (tannic acid antibacterial ointment) + strengthen local cleaning care
Treatment period】7 days of home treatment followed by outpatient review
Results】The child’s perianal eczema improved significantly, and the skin was restored to perfection.
I. Initial consultation
A parent brought her 3-month-old baby to the hospital and said that recently the skin near the anus of the child had obvious rashes and extensive skin redness, because recently she had changed diaper brands and felt that the size was not quite right. On examination, it was found that the perianal skin was obviously red and swollen with red papules, but no rash was seen on the rest of the body skin. Therefore, it was considered that the perianal eczema was caused by the inappropriate diapers and the irritation of diapers.
Second, the treatment process
Perianal eczema can usually be improved with proper care. Parents are advised to change the child’s diaper back to the one he or she used to wear and choose the right size. Localized skin can be applied with tannic acid antibacterial ointment, which has the effect of moisturizing the skin as well as repairing the skin barrier, and strengthening local care. In addition, since the child is a female infant, due to the physiological structure, the urethra and the anal opening are close to each other, so the perineal area is more sensitive. Rinse thoroughly with warm water after each bowel movement, then dry and apply some emollient lotion, and try to increase the exposure time of the local skin to keep it cool and ventilated.
III. Treatment effect
After changing the diapers, treating the buttocks cream and emollient lotion, and cleaning after each stool or urine. One week later, the parents brought the child back for a follow-up visit and saw that the perianal eczema had basically subsided and the skin had reappeared smooth, so the treatment was considered effective. The child’s sleeping condition also improved significantly, and he no longer cried.
IV. Notes
We are glad that after the treatment, the child’s symptoms have improved, but in daily life, parents still need to pay attention to some matters, such as the daily cleaning and care of the child’s perineum is very important, especially for female infants, due to the physiological structure, their urethral opening, vaginal opening and external anal opening are very close together, if urine and stool are not cleaned up in time, it will lead to local skin contact irritation, and even Infections can occur from outside to inside through the urethra or vaginal opening, causing vaginitis or urinary tract infections. In some cases, the symptoms are insidious, and the child may show unexplained fever, crying, depression, poor milk intake, etc., which require careful examination.
V. Personal insight
By understanding the situation of the child in this case, we can see that in daily life, it is necessary to choose the right size of diapers for the youngest babies in order to have the most comfortable wearing experience and the best effect. In addition, try not to go too long without changing the diaper, because once the excrement is more than the diaper can absorb, it will easily lead to local skin problems. Once localized perianal eczema appears, it is necessary to strengthen the care of the child. If at the same time the child is found to have violent crying, fever, poor spirit and reduced appetite, it is necessary to consult a doctor in a timely manner.