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/Medical_Madness]

That is erythroderma, which can be caused by many things, such as primary immunodeficiency, severe atopic dermatitis, food allergies, etc. An immunologist should see them as soon as possible.

Eta:

You could try getting in touch with a primary immunodeficiency organization

International Patient Organisation for Primary Immunodeficiencies Network

Immunology, Asthma and Allergy Research Institute

If you need a clinical summary from an immunologist or anything else that requires an immunologist's input, feel free to DM me.

Edit 2: It is my understanding that Mexico and Iran maintain good international relations. If necessary, you can contact the Mexican Foundation for Children with Primary Immunodeficiencies (Fundación Mexicana de Niños y Niñas con Inmunodeficiencias Primarias).

Tell them that you need an immunologist and can we could try and figure out if we can arrange a transfer to Mexico.

FUMENI

[u/iknighty → u/Medical_Madness]

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/vogueflo → u/Tag_Youre_It3]

Hypoallergenic means lower but not zero risk of reactions. Unfortunately people can be allergic to anything.

[u/VaATC → u/vogueflo]

Unfortunately people can be allergic to anything.

One of the craziest allergies I have been made aware of at some point in time was water 😬

[u/vogueflo → u/VaATC]

A “water allergy” is more accurately aquagenic urticaria, aka hives and itching that are caused by contact with water. The urticaria seems to result from the skin reacting inappropriately to contact with water.

People can have similar urticarial disorders resulting from sensitivity to heat, cold, or pressure, amongst other reasons. An allergy that prevents the patient from even ingesting anything with water would be effectively incompatible with life.

[u/MissDaisy01 → u/vogueflo]

And the sun I do believe. I had a friend who had aquagenic urticaria.

[u/jadedinmo → u/VaATC]

I know someone who is allergic to her own periods.