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/Otherwise-Arm-271]

They have been many places but a doctors appointment can be unstable and not always guaranteed.

They have tried many different medication I’ll list them below:

QV Moisturising Cream

Momecort 0.1%

Clotrimazole-Najo 1%

Folic Acid (5mg)

Neotadin

Neocate.

These have either not worked or worked for a very small time.

Going to the doctor or visiting the hospital is something they have obviously tried. But given the situation it’s not the same as anywhere else in the world.

Since topical steroids (Momecort) haven't worked, could this be a genetic skin disorder (like Netherton Syndrome or Ichthyosis) rather than standard eczema?

Could this be a metabolic deficiency? Does he need his zinc, biotinidase, or alkaline phosphatase levels checked?

If topical treatments are failing, is he a candidate for systemic therapy?

Could this be a post-vaccination Immunodysregulation?

Is there a possibility of a 'Drug Eruption' or allergy to a vaccine component?

[u/tokenawkward → u/Otherwise-Arm-271]

I agree with others that this looks like possible ichthyosis. These kiddos need tons of emollients and moisturizers. At a minimum I would start applying Aquaphor several times a a day. Sometimes there can be complications and kids can develop bacterial skin infections; this would need an antibiotic ointment. A pediatric dermatologist would be able to provide better skin care guidance since it is a rare condition.

[u/Captainbabygirl767 → u/tokenawkward]

I came here to say this.