WASHINGTON — As congressional Republicans move to solidify their Obamacare repeal-and-replace legislation, concern is mounting that their strategies will leave millions of Americans with less financial assistance and more expensive coverage. A new analysis on Wednesday from the Kaiser Family Foundation projects that the HealthCare.gov insurance marketplace’s average premium subsidy — which people use to help… Continue reading “GOP’s Obamacare replacement plans would provide less financial help, analyses show” »
CHICAGO — When Marathon Pharmaceuticals’ $89,000 price tag for a year’s supply of its newly approved muscular dystrophy drug sparked outrage earlier this month, the company’s CEO responded with another figure: $20. That’s how much he expected Duchenne muscular dystrophy patients would pay per prescription of the drug, he wrote in a letter posted on the… Continue reading “Pharma firm CEO insists $89,000 drug is affordable, but what’s the true cost?” »
Being thin and being in shape are not the same thing, as evidenced by our slender friends who never get off the couch, and conversely, by every single overweight athlete. Although our weights and where we fall on the body mass index — a measurement of our total body fat based on our height and weight… Continue reading “Are You In Shape Or Just Thin?” »
Let’s talk about lice. They’re pretty lousy; they itch, they can spread disease, and they’re just gross. Thankfully, SciShow host Hank Green can tell us more about lice than we could ever imagine, such as why we put our heads together to show how much we care — “to intentionally transmit head lice to your friends… Continue reading “7 Facts About Head Lice” »
It’s a grim reality many of us face: Promptly after eating cheese, we become sick. Should we persevere through our love of cheese and a helping of blissful ignorance, or face the fact that we may be lactose intolerant? According to the Mayo Clinic, the most common symptoms of lactose intolerance, when our bodies cannot fully… Continue reading “6 Signs Of Lactose Intolerance” »
Gunfire killed about 4,500 U.S. children and adolescents in 2015, and it sends about 20,000 to the emergency room each year, according to a new review by Children’s National Health System. Adolescents aged 12 to 19 comprise 90 percent of those ER visits. Related: NRA-backed law limiting doctors’ gun speech struck down The study by researchers… Continue reading “Gun-Related Injuries Put 20,000 Children a Year in ER” »
This article originally appeared on The Conversation. The health of rural America is failing, and a repeal of the Affordable Care Act (ACA) without adequate replacement could prove disastrous. A December, 2016, report from the Centers for Disease Control and Prevention showed that for the first time in 20 years, life expectancy in the United States… Continue reading “Rural America Could be Hardest Hit by Obamacare Repeal” »
Milly Silva After nearly seven years and dozens of failed attempts to repeal the Affordable Care Act (ACA), Republicans in Congress will soon get their wish. They will then own the responsibility for protecting the lives and livelihoods of countless New Jerseyans and Americans in general who currently benefit from the many popular components of the… Continue reading “Opinion: Health Crisis Looms if Obamacare is Repealed Before Replacement” »
An entertaining video guide for families to learn about how pain works and how to have more control over your pain, your body and your experience during medical procedures. Created by, Stanford Children’s Health and Produced by Booster Shot Media ©2017 Learn more at http://pain.stanfordchildrens.org.
When Is Diaper Rash not Just A Rash?
Diaper dermatitis is common and is usually easily treated. However, just like many other things in life, it can also get complicated. There are several scenarios that every parent, as well as providers, should be aware of in which a rash IS not a simple diaper rash. As we stated in a previous post, diaper rash as a clinical entity accounts for between ten and twenty percent of the in-office complaints that we see in children under 2 years of age. Even though it is called diaper rash and is found mainly in the diaper-covered areas of the infant, there are situations in which the rash goes beyond these areas. In such instances as well as in others with more severe clinical features, medical intervention is both necessary and urgently needed.
Below are four variants of complicated diaper rash that need medical intervention.
Candida Diaper Dermatitis:. The hallmark of candida diaper dermatitis is the red beefy raised areas of skin (the medical term is plaques). Other clinical characteristics are the presence of some superficial pustules that look as if they have pus in them. Also to aid in clinical diagnosis, one looks for satellite lesions. Essentially, with candida, it is a phenomenon whereby there will be some spots that are located away from the main area where the rash is present. It looks as if they are satellites thrown far away from the main bulk of the lesions. of the constant contact, that ensues when a child sits in a wet or stool-soiled diaper for a prolonged period. Chemicals from urine and feces irritate the wet skin, thus putting the top layer of the skin under chemical pressure. Eventually, the skin breaks out and the rash develops. As one may expect, candida diaper rash usually is preceded by a chemical diaper dermatitis often times due to urine irritation of the area. The disease process transitions into candida as soon as the skin folds start getting involved. Normal chemical irritants do not affect the skin folds. Although we diagnose this infection clinically without any lab tests, a laboratory scraping usually stained with KOH in the lab shows the candida components. Treatment is with topical (skin-applied) antifungal cream. On rare occasions, the infant’s candida infection persists.That gets your provider thinking and trying to expose or eliminate conditions like Type 1 diabetes and chronic mucocutaneous candidiasis.
Impetigo is Secondary Infection from Staphylococcus aureus (or S. pyogenes): This is a bacteria found literally everywhere. It has a subspecies that lives on the human skin and it also has some multi-drug resistant subspecies called MRSA. Impetigo is a common, itchy and fast-spreading (read contagious) skin infection. I have treated many children in the past with impetigo on other parts of their body. These are usually teens. Unfortunately, infants can have impetigo as a complication of a diaper rash. They have raised 2mm lesions that are fragile, may have some pus and do look like honey crusts when eroded. Some children have more serious infections called bullous impetigo where the lesions are much larger and rupture easily. The diagnosis is usually confirmed with laboratory testing of the pus. Treatment is with antibiotics. If the infant is under two months, we may decide to treat her as an inpatient because they are very delicate at this age and may be at a high risk for developing septicemia (bacteria multiplying in their blood). Furthermore, if the infant looks ill, has symptoms of being tired, not acting herself, or crying excessively or if she has a fever, further testing needs to be done along with immediate treatment.
Perianal excoriation due to streptococcus:. Infections in the area covered by diapers can indeed get complex. This infection in the area around the anal opening is caused by group A streptococcus infection. The area looks red and inflamed. There is a sharply demarcated area of redness and other parts of the diaper area may also be red. When this has been around for a while, the child may develop perirectal fissures and blood-streaked stools. Fissures are notorious for causing pain on stooling so this may be an indication if your child has distress doing ” number 2″. Treatment is with antibiotics after a thorough examination by the provider.
Herpes Simplex Virus Infection. Some infants develop vesicles, papules or pustules caused by HSV virus. HSV is known to be sexually transmitted so is an infant develops herpetic lesions, this is a red flag for potential child abuse. Such cases are not common but do occur. If it is suspected, we initiate an investigation of child sex abuse and this includes both the law enforcement agents and child protective services. Herpes is treated with antiviral agents, but more pertinent is the safety of the child from a potential abuser. As we have seen, there can be serious complications of diaper rash that require more detailed management and treatment. It is important that parents understand the need to seek medical attention whenever they notice things unusual with their child. Second guessing and “watching it for a while” may not always be the best decision though reasonable at times.
Here at Omega Pediatrics we ensure that parents have access at all times so that they can reach us for decisions about their child’s health. Read other blog posts here.
What have you experienced with diaper rash? Please comment below and feel free to share this blog post.
Comment below or on our Facebook Page. Please share this article.
Omega Pediatrics Difference: At Omega Pediatrics in Roswell, Georgia we understand the challenges that parents face when their children develop symptoms late in the day or after hours. Many pediatric offices are closed after 4 pm however we are open every weekday up to 9 pm for walk-ins and we have telemedicine via evisits for our known patients. Our clinic is one of the easily accessible pediatric primary care clinics in Roswell and Alpharetta. We provide pediatric primary care to families in the North Fulton area and we have families that live in Sandy Springs, Johns Creek, Duluth and Cumming.
Immunizations after-hours: One advantage of switching to Omega Pediatrics for your child’s primary care is that you can bring your child in for immunization after regular business hours. We provide this service because we have the passion for what we do and we want to be a comfortable and convenient service, not the ordinary pediatric doctor’s office.