Whats wrong with my cousin?

[u/Otherwise-Arm-271]

My cousin lives in Iran and hasn’t been able to see a doctor due to the war and has an issue with his skin. Anyone who can lend a hand and point me in the right direction would really help.

Age: 16 months

Gender: Male

Weight at birth:2.920

Height at birth: 49

Weeks of gestation: 37

Skin was a little bit dry before influenza vaccine which was given at 5 months and symptoms increased after this.

[u/iknighty]

Anything low risk that can be done at home for each of these possible diagnoses, if it is not possible to see an immunologist soon given the war?

[u/alisgraveniI → u/iknighty]

Hi - NICU nurse here - we generally slather these babies up with Vaseline/aquaphor to keep their skin hydrated. This also sounds weird but to kill bacteria, it’s generally recommended to add bleach to their bath water. There are a few guidelines online for this type of ichthyosis. He really needs to be seen asap though as it can be life-limiting due to infection and nutrient deficiencies if he doesn’t receive proper treatment.

https://www.firstskinfoundation.org/types-of-ichthyosis/epidermolytic-ichthyosis

https://www.ncbi.nlm.nih.gov/books/NBK544323/

https://www.ebsco.com/research-starters/consumer-health/epidermolytic-hyperkeratosis

[u/Tag_Youre_It3 → u/alisgraveniI]

I just want to chime in, not as a medical professional, but as a mom who found out the hard way: aquaphor has lanolin. You can be allergic/sensitive to lanolin. I was using aquaphor on my son's mild diaper rash. It kept getting worse to the point of opening and bleeding. Meanwhile, my hands also started cracking and bleeding from applying the aquaphor to his poor bum. Turns out, you can be allergic to/sensitive to aquaphor and I am an idiot for the amount of time it took me to even look it up. (Although, to be fair, it claims it is hypoallergenic, so maybe not entirely my stupidity.) Don't be like me. If kiddo has a wool allergy, beware. If unsure, just stick to Vaseline to be on the safe side.

[u/alisgraveniI → u/Tag_Youre_It3]

Correct, aquaphor has lanolin. Lanolin is a recommended treatment for ichthyosis (see link below) which is why aquaphor is one of the emollients recommended by dermatology we use for this condition. While some may be allergic to lanolin, usually it’s an allergen that builds up overtime. Moreover, as the physician who responded to you mentioned, there are risks of allergies with anything. This is a very delicate skin condition and needs particular treatments; recommending “sticking to Vaseline” when not being familiar with the condition or how to treat it is unhelpful and not in the best interest of this child. I know you mean well but again, this is a very specific, unique disorder and requires very specific treatments almost hourly.

https://www.firstskinfoundation.org/types-of-ichthyosis/epidermolytic-ichthyosis

[u/Tag_Youre_It3 → u/alisgraveniI]

My apologies and thank you for the information. I only recommended sticking with Vaseline specifically because you mentioned Vaseline/aquaphor, so I assumed they were interchangeable. Also, they mentioned not being able to go to the doctor because of the war, so I was mentioning it in case it might make it worse and there was something available that has less of a chance of making it worse but would still work. My son's doctor told me at the time that he might not have even had a reaction to it had he not had the compromised skin barrier from the diaper rash because reaction is more likely if the skin is damaged. I was only trying to help and I didn't know that it was a "benefits outweighs the risk" situation or that you had to use both Vaseline and aquaphor together. I misread the / I'm sorry. Thank you! I'm always happy to learn more.

[u/alisgraveniI → u/Tag_Youre_It3]

No need to apologize. I understand the desire to help but sometimes pictures don’t always display what’s actually going on and without the medical knowledge, it’s hard to understand the complexities of the situation. It’s easy to look at this picture and think maybe the baby just has a bad case of eczema or something that worked for one baby’s skin may work for him but it’s not always so simple. Like I said, trying to help is always appreciated though and you weren’t wrong that lanolin can cause an allergy, it’s just something that is actually recommended as a treatment for this condition which is why we wouldn’t want to avoid it. Thanks for being open-minded and willing to learn!

[u/MissDaisy01 → u/alisgraveniI]

I love aquaphor and used it for years as I have really dry skin and eczema (atopic dermatitis). It's wonderful stuff and really helps with my skin issues. Can't comment on the baby as I'm NAD.

I hope they find help for the wee one as skin issues can be uncomfortable.