Weird diaper rash - any thoughts?

[erosenst]

Abby has had a strange diaper rash for over month - bright red pimples, mostly on her labia, but occasionally moving toward her butt and into the creases of her legs. Have been to the ped a few times (once specifically for this, twice for other reasons!) while she's had it. Started out with "benign neglect" - just using A&D and Desitin as a block. It got worse, and ped suggested betamethasone (generic for Diprosone) and changing brands of diapers temporarily, as he thought it was a reaction from the interaction of urine and chems in her diaper. It got a little better, then looked like it was developing into a yeast infection, too. Ped suggested adding Lotrimin twice a day, which cleared up the yeast problem. However, original problem is still there.

It seems to clear up on the weekends, and get worse at daycare. I know they're using all the "stuff", as I've had to replace it. They change her at least as often as we do, so that's not it either. Any other thoughts on what this could be/what we should be doing? Good news is that, other than during the yeast infection, it doesn't seem to be bothering Abby at all!

Thanks in advance for your help -

[amp]

My first thought was yeast infec, but you say you treated for that and that's not it. My next stop would be www.askdrsears.com. You can see pics and descriptions of some of the rashes to help identify it. Try this page first, and if that doesn't help, try searching on diaper rash on the website...

http://www.askdrsears.com/html/8/t081400.asp

[Karenn]

Is there something different that they are feeding her at daycare that you don't feed her at home? When he was younger DS would get that kind of bumpy diaper rash when he ate wheat. I stopped feeding him wheat for several months and he was able to eat it again when he was closer to 18 mos. old. For awhile though, every time he had a little bit of wheat, he would get that same diaper rash.

[erosenst]

Thanks for the input. The ped (and I) were pretty sure the yeast part was cleared up because it was not longer in the creases - the favorite spot for yeast! In addition, her yeast infections (previously caused by Augmentin) tend to be VERY red, flat, and contiguous.

Interesting about foods - she does eat differently at daycare - lots more starches and sugars. However, she's definitely not wheat free at home on the weekend - but *maybe* the quantity is making a difference?

The other thing I've wondered is whether they're using too MUCH of the prescription cream - they go through it much faster than I do. Will call the pharmacist, and perhaps the ped, about that in the morning. Until then, interested in other thoughts!

[kmpilgrim]

I really don't have advice for what may be causing the rash, however my daughter had a rash that didn't seem to go away - even with prescription creams. The only think that worked was Triple Paste. You may have already tried this, but I thought I'd pass on the name. Most pharmacies stock it, and it is available without a prescription.

Hope it clears up soon.

Kristin
Chas 07/99
Kate 09/01
Paul 01/05

[erosenst]

After reading the replies here,and thinking about it some more, I started focusing on the differences between home and daycare. It occurred to me that they might be using wipes when she just has a wet diaper - I don't do that. Also, she sleeps more and eats less on the weekend, so she doesn't poop as much - therefore, even less wipes. I confirmed that they have to use wipes (or something) by state law every time she's changed.

Called the ped's office. I asked about the wipes - the nurse was astounded we hadn't already stopped them, as that's usually the first thing they recommend. Let's see - 4 calls to the nurse line, and 3 ped visits (one for another illness, one for well-baby, one specifically for the rash, although it was looked at the other two times) and NO ONE mentioned the wipes. I think everyone assumed I already knew it because she's 18 months old. (OK, and I'm somewhat of a research nut, too, so I usually have a good idea of what the treatment options may be, etc...)

So - we're going to try no wipes for a few days and see what happens. Of course, she had a REALLY bad diaper today (I would usually call it a 4-wiper). Much harder to work with a washcloth - I've gotten spoiled being able to just throw the wipes away as they get dirty. Hopefully it will help, though.

Thanks again for all the suggestions.