Dry red patch on baby face

Managing Eczema in Winter and Year Round: A Parents Guide

Cold, dry outdoor air and indoor heating can rob skin of its natural moisture in the winter. Red, crusty, dry patches can be common on a baby's skin, particularly in winter, and cause concern for parents. Such symptoms can be treated, however, and many babies and children do outgrow the dry, itchy skin of atopic dermatitis, also known as eczema.

We spoke with pediatric dermatologist Katherine Puttgen to learn more.

What is eczema?

Broadly speaking, eczema describes dry, rashy and itchy skin. It is a hereditary and chronic skin disorder most commonly seen in infants or very young children, often beginning in the first year of life and most commonly seen before age 5. Eczema is not contagious.

While many children outgrow eczema, for some it might last into adolescence or adulthood. The American Academy of Dermatology estimates that 10-to-20 percent of children in the world have eczema, and it affects up to 20 percent of infants.

What causes eczema in infants and children?

Eczema is brought about by the complex interplay of a genetic predisposition and the child’s environment. Many things – from the climate to possible allergens – can cause eczema to flare. We know that eczema tends to run in the families with a predisposition to other atopic diseases, such as food allergies, asthma and hay fever. Individuals with atopic dermatitis may lack certain proteins in the skin, which leads to greater sensitivity. Parents with eczema are more likely to have children with eczema. However, the exact way it passes from parents to children is still not known. Most children who have eczema will show signs of the condition in the first year of life. It tends to wax and wane in severity.

What causes eczema to wax, to flare?

Different "triggers" can make eczema worse. For infants, these can be irritants such as wool, certain detergents or extreme temperatures, or other immune triggers, such as food allergies and asthma, and even pet dander.

Most kids with the condition have the hardest time in winter, when the air is cold and dry. A small percentage has a harder time in the summer, when it is hot and humid.

What does it look like?

The signs of eczema in infants include itchy, dry and scaly skin, redness and swelling of the skin and small bumps that open and weep when scratched. In infants and young children, eczema is usually found on the face, outside of the elbows, and on the knees.

In older children and adults, eczema tends to be on the hands and feet, the arms, and on the back of the knees.Keep in mind that all patches of dry skin are not eczema. The cold, dry outdoor air and indoor heating can dry all babies’ skin in winter, causing dry patches. In children prone to dry skin, so can the sun, air conditioning, and pool and salt water.

We dermatologists usually say “if it’s not itchy, it’s not eczema”; you can’t make a diagnosis of eczema unless there is an itchiness that goes with the rash. Babies with cradle cap, also known as seborrheic dermatitis, can also have a wide-spread rash, which is not eczema in itself. But it is common for cradle cap and eczema to co-exist in the first several months of life.

How is eczema diagnosed?

Eczema symptoms may resemble other skin conditions, so always consult your child’s pediatrician. A diagnosis includes a complete medical history and a physical examination.

How is it treated?

Because there is not yet a cure for eczema, our treatment goals are to reduce itching and skin inflammation, and to prevent infection. The best treatment for eczema is a proactive one, using gentle skin care and moisturizers to re-establish the skin barrier.

Infants’ and older children’s skin should be kept well moisturized, and washed with fragrance-free non-soap cleansers. We also recommend a fragrance-free ointment-based moisturizer, with petrolatum as either the only or the first ingredient. In young children and infants, it is reasonable to use an over-the-counter topical hydrocortisone ointment, which is a mild topical steroid, for up to a week.

But if the rash either persists or you find that you need to use the hydrocortisone more than one week out of the month, you should discuss further use with your child’s pediatrician. You can apply the ointment, as prescribed, then a coat of petrolatum-based moisturizer, to help keep in the moisture.

For school-age children, who don’t want to be so greasy, we usually talk about creams. As for infants, though, when their skin gets very dry, we still recommend a petroleum-based ointment as a top coat. In addition to providing the best barrier protection, ointments don’t sting or burn when applied; creams and lotions sometimes can when the skin is inflamed and very dry. Moisturizers should be applied at least two to three times a day; for children in diapers, each diaper change can present an easy opportunity to moisturize the skin. More frequent use of moisturizers results in better control of itching and less frequent need for topical steroids, and it helps to restore the skin’s natural barrier function.

For all ages of kids with eczema, or prone to eczema, baths should be brief (less than 15 minutes) in warm water, to avoid over-drying of the skin. Children should be protected against scratching their skin (little mitts can help infants) and from irritants that contact their skin, such as harsh detergents and certain fabrics (including bedding). To reduce potential skin irritation, babies and children with eczema should wear only cotton or other natural fiber clothing next to the skin, with the exception of wool, of course. And they should be protected against cold (or very hot) environments to help prevent a skin reaction.

If your child’s skin does not respond well to any of these measures or becomes infected, contact your pediatrician, who can diagnose the condition and then prescribe another topical cream or antihistamine.

Is a cure or better treatment for eczema on the horizon?

Without a cure on the near horizon, we here at Johns Hopkins are creating an Eczema Day Treatment Unit to help our patients with moderate to severe eczema keep their symptoms under control and prevent flare-ups. We anticipate that this novel, multidisciplinary program will include experts from Child Life, behavioral psychology, allergy, dermatology and infectious diseases to provide the comprehensive care these children need – care that cannot be provided in an average clinic visit.

A primary goal of the day treatment unit will be education; children and their families will learn techniques such as wet-wrap therapy, to help deeply moisturize the skin. This therapy involves coating the skin with a topical ointment, followed by a greasy ointment like petroleum jelly, then dressing in wet pajamas, followed by dry pajamas, allowing the skin to soak in the moisture.

In partnering with our colleagues in behavioral psychology, we have seen many of our patients with severe eczema improve significantly with help in finding ways to avoid scratching, which inflames their skin condition, and by helping older children talk about the social difficulties in coping with a chronic condition or going to school with a visible disorder. Child Life specialists are an integral part of the Johns Hopkins Children’s Center and their ability to engage children in age-appropriate play and conversation is an important cornerstone of building a successful program. Because food and environmental allergies and skin infections are more frequent in children with moderate to severe eczema, strong partnerships with our experts in pediatric allergy and infectious diseases are key, as well.

What about research?

At Johns Hopkins, a lot of us in pediatric dermatology, pediatric infectious disease and pediatric allergy and immunology are looking at better ways to prevent or manage eczema. We’re studying the optimal management of bacterial colonization and infection in atopic skin and the role of food allergy in eczema. Our specialties collaborate; each brings a different approach to eczema management. Our goal is to work together to harness the best approaches to better understand eczema and, in doing so, to treat it more effectively.

What else is happening at Johns Hopkins today?

We go out of our way to provide the comprehensive care our patients with eczema need. On a case-by-case basis, we communicate with one another – whether in allergy, dermatology, psychology or infectious disease – to put together the best course of treatment for each child.We are optimistic that future therapies and approaches to care for those with even severe eczema are going to be greatly improved with more research and that the creation of the Eczema Day Treatment Unit will help us conduct cutting edge research and answer questions we face every day seeing and treating patients.

Like other atopic diseases, such as food allergies, is the incident of eczema in children increasing?

Yes. We don’t really know why. But we’re on the case to find answers.

Scarlet fever - NHS

Scarlet fever is a contagious infection that mostly affects young children. It's easily treated with antibiotics.

Check if you have scarlet fever

The first signs of scarlet fever can be flu-like symptoms, including a high temperature, a sore throat and swollen neck glands (a large lump on the side of your neck).

A rash appears 12 to 48 hours later. It looks looks like small, raised bumps and starts on the chest and tummy, then spreads. The rash makes your skin feel rough, like sandpaper.

On white skin the rash looks pink or red. It may be harder to see on brown and black skin, but you can still feel it.

Credit:

BIOPHOTO ASSOCIATES/SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/262529/view

A white coating also appears on the tongue. This peels, leaving the tongue red, swollen and covered in little bumps (called "strawberry tongue").

Credit:

SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/262413/view

The rash does not appear on the face, but the cheeks can look red. The redness may be harder to see on brown and black skin.

Credit:

ISM/SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/101463/view

The symptoms are the same for children and adults, although scarlet fever is less common in adults.

Non-urgent advice: See a GP if you or your child:

have scarlet fever symptoms
do not get better in a week (after seeing a GP)
have scarlet fever and chickenpox at the same time
are ill again, weeks after scarlet fever got better – this can be a sign of a complication, such as rheumatic fever
are feeling unwell and have been in contact with someone who has scarlet fever

Scarlet fever is very easily spread. Check with a GP before you go in. They may suggest a phone consultation.

What happens at your appointment

GPs can often diagnose scarlet fever by looking at your tongue and rash.

Sometimes they may:

wipe a cotton bud around the back of your throat to test for bacteria
arrange a blood test

Treating scarlet fever

A GP will prescribe antibiotics. These will:

help you get better quicker
reduce the chance of a serious illnesses, such as pneumonia
make it less likely that you'll pass the infection on to someone else

Taking antibiotics

Keep taking the antibiotics until they're finished, even if you feel better.

Things you can do yourself

You can relieve symptoms of scarlet fever by:

drinking cool fluids
eating soft foods if you have a sore throat
taking painkillers like paracetamol to bring down a high temperature (do not give aspirin to children under 16)
using calamine lotion or antihistamine tablets to ease itching

How long scarlet fever lasts

Scarlet fever lasts for around 1 week.

You can spread scarlet fever to other people up to 6 days before you get symptoms until 24 hours after you take your 1st dose of antibiotics.

If you do not take antibiotics, you can spread the infection for 2 to 3 weeks after your symptoms start.

Important: Important

If you or your child has scarlet fever, stay away from nursery, school or work for 24 hours after you take the 1st dose of antibiotics.

Is scarlet fever dangerous?

Scarlet fever can be a serious illness, but thanks to antibiotics, it's less common than it used to be and easier to treat.

But cases of scarlet fever have increased in recent years. For more information see GOV.UK: Scarlet fever guidance and data.

Complications from scarlet fever are rare. They can happen during or in the weeks after the infection, and can include:

ear infection
throat abscess
sinusitis
pneumonia
meningitis
rheumatic fever

Pregnancy advice

There's no evidence to suggest that getting scarlet fever during pregnancy will harm your baby.

But it can make you feel unwell, so it's best to avoid close contact with anyone who has it.

Contact a GP if you get symptoms.

Many of the antibiotics used for scarlet fever are considered to be safe to take during pregnancy.

How to avoid spreading scarlet fever

Scarlet fever is very infectious and can easily spread to other people.

To reduce the chance of spreading scarlet fever:

Do

wash your hands often with soap and water
use tissues to trap germs from coughs or sneezes
bin used tissues as quickly as possible

Don’t

do not share cutlery, cups, towels, clothes, bedding or baths with anyone who has symptoms of scarlet fever

Page last reviewed: 29 June 2021
Next review due: 29 June 2024

Plaques on the skin - causes, diseases, diagnosis and treatment

INVITRO
Library
Symptoms
Plaques on the skin
Fungus

Allergy

Psoriasis

Keratoma

Mycosis

Nevus

Melanoma

9675 November 16

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

Plaques on the skin: the causes of occurrence, in what diseases they occur, diagnosis and methods of treatment.

Definition

A plaque is a pathological element with clear edges that rises above the skin surface or merges with it, more than 5 mm in size.

In dermatology, many types of plaques are distinguished - about 70 diseases occur with the formation of these elements, which makes the plaque one of the most common rashes.

Plaque varieties

The shape of the plaques are round, oval and irregular in shape. Over time, the shape, surface and appearance of this element may change.

Due to the occurrence of plaques, they can be both a manifestation of skin diseases and a symptom of diseases of internal organs and systems (autoimmune reactions, liver diseases, oncological processes, allergic reactions).

Plaques are dry, smooth, red, brown, gray-white, etc.

Possible causes of plaques

Dry plaques on the skin in adults may be a manifestation of the following diseases: plaques with severe itching.
Allergic reactions are characterized by the appearance on the skin of smooth dry plaques, pink spots, blisters, which are very itchy and cause severe discomfort. They can develop both when the skin comes into contact with the allergen, and when it gets on the mucous membranes (for example, with urticaria, hay fever, food and contact allergies).
Psoriasis is a chronic non-infectious skin disease in which scaly dry plaques form on the elbows, knees, scalp, prone to fusion and accompanied by mild itching.

Dry plaques form on the skin if it is exposed to stress for a long time with the loss of its protective functions.
Diseases of the digestive tract, accompanied by malabsorption syndrome (impaired absorption of vitamins and trace elements in the small intestine), chronic diseases of the liver and other organs, in which substances that are not normally present in the dermis accumulate, also lead to the appearance of dry plaques.
Solar keratoma is a precancerous condition, which is characterized by the presence of many light grayish plaques on the skin.

The appearance of red plaques on the skin indicates their good blood supply. Possible causes of this condition may be the following nosologies:

Drug toxidermia is an allergic reaction accompanied by the appearance of elements in the form of plaques on the skin. In severe cases, Lyell's syndrome or Stevens-Johnson syndrome, toxic epidermal necrolysis, may develop.

Dühring's dermatitis (herpetiform) is a chronic skin disease with no established etiology, which is characterized by recurrent appearance of a rash of various morphologies on the skin, accompanied by severe skin itching and burning.
Mycosis fungoides is a primary T-cell lymphoma of the skin, a malignant lymphoid lesion, primarily of the skin. Itchy red plaques appear on the skin, resembling eczema. In the initial stages, they respond well to treatment with hormonal ointments, but the disease itself requires more complex therapy.

In children, the appearance of red spots and plaques on the skin is most often associated with an allergic reaction to food.

Brown plaques occur when melanin is deposited in the affected area of the dermis, which causes a brown (dark) color. Possible causes may be the following diseases:

Becker's nevus is an anomaly in the development of the dermis, when dark plaques with an uneven surface appear on the skin, on which hair can begin to grow over time.
Pigmentary nevus - "birthmark", may rise above the skin, has a brown or dark color.
Melanoma is the most malignant skin tumor characterized by rapid metastasis. It develops mainly from nevi and moles. If the nature of the surface, the boundaries of the mole change, its size increases, bleeding occurs, you should immediately contact a dermatologist or oncologist to exclude the development of melanoma.
Basal cell skin cancer is more often localized on the head, face, neck, does not metastasize, is characterized by slow growth.
Senile keratoma occurs in elderly people, most likely due to a lack of vitamins, an abundance of animal fats consumed, skin sensitivity to ultraviolet radiation due to a violation of its protective functions. Typical localization - face, neck, open areas of the body.
Seborrheic keratoma is a yellowish plaque on the skin that eventually transforms into a dark brown growth that tends to flake off, itch severely, crack, bleed, and can serve as an entryway for infection.

Which doctors to contact

With the formation of plaques on the skin, it is necessary to contact a dermatologist to determine the causes of the appearance of this element of the rash.

Plaque diagnostics and examinations

For the diagnosis of fungal skin lesions, scraping from the affected area is used for subsequent microscopic examination.

The development of an allergic reaction requires seeking medical help to identify the allergen, prescribing antihistamines, and sometimes hormonal drugs. In clinical cases of allergy, along with skin tests, analyzes are performed using various sets of common allergens and triggers: a panel for respiratory allergens, for food allergens, and for a combination of both.

Respiratory Panel

Synonyms: Comprehensive Respiratory Allergen Test Panel; Respiratory allergens panel, Allergen respiratory profile, Allergy testing. Brief description of the study "Panel respira...

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5 515 RUB

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Food Panel, IgE

Food Allergen Panel: hazelnut, peanut, Walnut, almond, cow's milk, egg white, egg ...

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5 515 RUB

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Food and Respiratory Panel

Panel different allergens: A mixture of grass allergens: fragrant spikelet; perennial rye; timothy; rye cultivated; Woolly buckthorn (GP3) IgE . ..

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In psoriasis, seeing a dermatologist and a rheumatologist can help reduce the symptoms of the disease if appropriate therapy is prescribed. For the diagnosis, it is usually sufficient to examine, determine, the skin manifestations of psoriasis are so characteristic, but if necessary, a differential diagnosis is carried out, including a clinical blood test, feces for the presence of worm eggs and protozoa, and a histological examination of the skin.

Clinical blood test: general analysis, leukoformula, ESR (with microscopy of a blood smear in the presence of pathological changes)

Synonyms: Complete blood count, UAC. Full blood count, FBC, Complete blood count (CBC) with differential white blood cell count (CBC with diff), Hemogram. Brief description of the study CBC: general...

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RUB 810

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Fecal test for helminth eggs

Synonyms: Feces on worm eggs; Analysis of feces for eggs of worms. Ova and Parasite Exam; O&P; Stool O&P test. Brief description of the study "Analysis of feces for eggs of helminths&ra...

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Available with house call

RUB 570

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Fecal analysis for protozoa (PRO stool)

Synonyms: Analysis of faeces for protozoa. Parasite Exam, feces; Parasitic Examination, fecal. Brief description of the study "Analysis of feces for protozoa" Fecal analysis for ...

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RUB 570

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Histological examination of biopsy material and material obtained during surgical interventions (endoscopic material; tissues of the female reproductive system; skin, soft tissues; hematopoietic and lymphoid tissue; bone and cartilage tissue)

Taking biomaterial is paid separately. According to the requirements of clause 17 of the Rules for conducting pathological and anatomical studies, approved. Order of the Ministry of Health of Russia. ..

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2 880 RUB

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Diseases of the stomach and intestines can also lead to plaque formation on the skin. To identify the pathology of the gastrointestinal tract, it is enough to refer to therapist or gastroenterologist, conduct a number of endoscopic examinations (gastroscopy, and, if necessary, colonoscopy), ultrasound of the abdominal organs, perform some screening blood tests for diseases of the liver, intestines, stomach.

Gastroscopy

Examination of the mucosa of the upper gastrointestinal tract with the possibility of biopsy or endoscopic removal of small pathological ...

RUB 4,440 Sign up

Colonoscopy

Endoscopic examination of the colon to look for abnormalities, perform biopsies, and remove small polyps and tumors.

RUB 5,740 Sign up

Comprehensive ultrasound examination of the abdominal organs (liver, gallbladder, pancreas, spleen)

Scanning of the internal organs of the abdominal cavity to assess its functional state and the presence of pathology.

RUB 2,890 Sign up

Liver function tests: screening

Up to 1 business day

Available with house call

RUB 1,935

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Diagnosis of celiac disease: intolerance to cereal proteins (gluten)

Up to 8 working days

Available with house call

7 520 RUB

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Gastropanel

Up to 9 working days

Available with house call

RUB 4,760

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To clarify the diagnosis of keratoma, a skin biopsy is performed and epithelium scraping is performed, followed by microscopic and histochemical examination.

Up to 5 working days

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2 880 RUB

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Examination of scrapings and impressions of tumors and tumor-like formations

Material for research. Imprints and scrapings are obtained from pathological lesions of the skin and mucous membranes (except for the cervix and cervical canal). Relative to test...

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RUB 1,030

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If atypical cells are detected in scrapings or biopsies, immediately contact oncologist.

If xanthoma appears on the skin, it is recommended to consult a cardiologist, take blood tests for lipid profile and blood glucose levels, and screen for diabetes.

Lipid profile screening

Up to 1 business day

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1 355 RUB

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Glucose (in the blood) (Glucose)

Research material Serum or blood plasma. If it is not possible to centrifuge the sample 30 minutes after collection for serum/plasma separation...

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335 RUB

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Diabetes management: advanced

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RUB 5 820

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What should I do if plaque appears on the skin?

Any newly appeared neoplasms should be shown to a dermatologist. Their cosmetic removal without prior consultation with a specialist is fraught with serious consequences.

In addition, there are symptoms that require immediate medical attention:

change in the shape of the plaque - the edges have become uneven;
change in the surface of the plaque - cracks, ulcerations appeared;
change in the size of the plaque - it began to grow rapidly above the surface of the skin or actively spread through it;
discoloration of the plaque - in cases of malignancy, an uneven color of the formation is usually observed with areas of darker and lighter shades;
the appearance of bleeding - both contact and spontaneous;
enlargement of regional (nearby) lymph nodes.

Plaque treatment

When plaques of an allergic nature appear on the skin, antihistamines are prescribed, in cases of a severe course of the disease, glucocorticosteroids. In addition, it is important to follow a hypoallergenic diet.

Mycotic plaques require antifungal drugs, both local (ointments, creams) and systemic (tablets). Taking these drugs is associated with a high risk of side effects, and therefore it is possible only after consulting a doctor, accurate verification of the diagnosis and confirmation of the etiology of the disease.

Treatment of psoriasis is multi-stage and complex, it involves constant monitoring by a rheumatologist, taking cytostatics and other drugs, using ointments and shampoos to improve skin condition, using antihistamines to reduce itching, including physiotherapy and a hypoallergenic diet in the treatment regimen.

When confirming the presence of diseases of the gastrointestinal tract, properly selected therapy can stop the appearance of new plaques on the skin, as well as prevent the development of complications of the underlying disease.

Sources:

Clinical guidelines. Dermatitis herpetiformis // Russian Society of Dermatovenerologists and Cosmetologists. 2016.
Clinical guidelines. Urticaria in children // Union of Pediatricians of Russia; Russian Association of Allergists and Clinical Immunologists. 2018.
Clinical guidelines. Toxidermia // Russian Society of Dermatovenerologists and Cosmetologists. 2016.
Clinical guidelines. Familial hypercholesterolemia // National Society for the Study of Atherosclerosis. 2018.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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Red dry spots on the skin of a child, on the face, hands

Tips for mothers

Causes of redness on the skin of a child

In newborns, the skin is sensitive due to the fact that the sebaceous glands have not yet adapted to produce protective substances.

Red dry spots on the skin of a child may be a reaction to weather conditions

Photo: Getty

Red spots on the face of a baby and on other parts of the body may appear due to the aggressive effects of the environment: dry or cold air, exposure to sun or frost

This can be a reaction to hard water, unsuitable bathing products or washing clothes.

The cause of redness on the skin of the baby may be the mother's menu: excessively spicy or allergenic food.

With the elimination of aggressive factors and good care, unpleasant symptoms will disappear by themselves.

But sometimes red spots signal dermatitis that needs treatment:

Atopic or allergic. The spots are single, appear on the body or limbs.
Seborrheic. The reddened areas are covered with a yellowish crust on top. Most often, a fungal infection occurs in the first month after birth. Without treatment, this condition drags on for several years.
Diaper. Redness is localized in the buttocks and genitals. They can flake and cause itching. A grayish coating indicates a concomitant fungal infection.
Contact. Red spots and streaks appear in places where the rough seams of clothing are rubbed. Treatment is needed here if the affected areas are inflamed.

Red spots on a child's arms or legs are not only caused by allergic dermatitis. Often they are a reaction to insect bites.

In addition to dermatitis, rounded redness on the body of the crumbs may appear due to pink lichen. This fungal infection is transmitted from person to person. Children attending nurseries and kindergartens are more likely to suffer from it.

Reddish spots are due to dysbacteriosis. Also, different types of skin redness can indicate various infectious diseases: rubella, measles, scarlet fever, chickenpox. Usually they are accompanied by poor health and fever.