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What Causes Foamy Stool And Perianal Dermatitis

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Posted on Mon, 24 Aug 2015
Question: Hi,

My 14 month old has been passing foamy stool for the last few days. However, since today morning, she has been passing liquid stool (mucus and greenish). It looks like an amoebic dysentery. We observed that for the last 4-5 days she has developed some rashes in her skin .
My Pediatrician said that rashes are common in perianal region during loose stool. The peri anal dermatitis is due to the acidic consistency of stool. He suggested to give her Siloderm which contains zinc oxide thrice a day.
But as the situation is not under control we took a second opinion and the other doctor suggested me to apply Vaseline and Proctoguard ointment thrice daily.
Can you please check the Day-1, Day-2 and Day- 3 pic and let me know your impression on this…
Is this diper rash, or some rash due to acidic stool or topical fungal infection or something else…? Does she need to take any antibiotics for this skin issue or we can avoid any oral medicine as she is just 14 months old.

Thanks and Regards
XXXX

The issue is if you look into the Day-1, 2, 3 pics you will understand that even after application of the ointment day by day the skin rash is aggravating!!

Is this normal due to acidic stool or something we are not addressing ?
doctor
Answered by Dr. Sanjay Kumar Kanodia (5 hours later)
Brief Answer:
Diagnosis of peri anal dermatitis. suggestions as below.

Detailed Answer:
Hello,

Welcome and thanks for posting your query to the forum.

I can understand your concern for the peri anal rash in your little baby.

I have diligently analyzed the complete query along with the day 1, 2 and 3 pictures. After analyzing the complete condition let me reassure you first that your doctor is correct in his/her diagnosis of peri anal dermatitis.

If you can observe the affected area then can make out that there is rim of redness which is progressively increasing. There is slight vasculature in the day 3 pictures along with redness. All these features favors the peri anal dermatitis.

In order to take care of the condition I suggest you to kindly follow the suggestions for next 24 hours :

- Take XXXXXXX Warm water and clean the area for two minutes. Take a cotton ball and clean the area gently. Mop it gently with tissue paper every time after cleaning and otherwise a better so in 1 to 2 hours.

- Do it for 4 to 5 times. You can clean the area every time the baby is passing the stool.

- If it is possible to not to apply diaper then would be best of policy for next 24 hours. Rather than using a diaper, a plane cotton cloth would be better. I know this sounds bit difficult but would be a better policy at this time. As the peri anal area is already moist and diapers make it more worsened.

Do not apply any medication for next 24 hours. Let it heal by itself. If a better lot all you want to apply the medications then use a pea size amount for palm size area and that too should not be visible to the naked eye. But preferably avoid medication.

I additionally suggest you to give zinc syrup. You can talk to the treating doctor for the same. Many times continuous diarrhoea causes zinc depletion and accordingly more chances of such kind of rash.

I hope all this information will help you. My best wishes for speedy recovery.

With regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sanjay Kumar Kanodia (2 days later)
Hi Doctor,

Thanks for your response.
Just wanted to show the day-5 pics where the skin problem is getting aggravated and I am afraid if this is now a fungal infection?

Do you suggest any medicine like Proctoguard or Candid?

Thanks and Regards
doctor
Answered by Dr. Sanjay Kumar Kanodia (6 hours later)
Brief Answer:
I would had preferred Mupirocin cream at the affected area.

Detailed Answer:
Hello,

Welcome back and thanks for your follow up.

I have analyzed the pictures of day 5. Let me reassure you that it appears to be better than day 3 picture. If you can notice the area is not red now. In day 3 picture you can see that the area was quite red and inflamed.

In day 5 pictures you can see that the area dried up and accordingly we can see flaking at the affected area. The only concern now is the few pus points. The area is bit infected at certain places. I suggest you to show the area to dermatologist. If I were the treating dermatologist then along with suggestion in the previous mail, would had preferred to apply an antibiotic cream. I would had preferred Mupirocin cream at the affected area.

I also suggest you to avoid diapers,keep the area dry and air dry area after washing. Make it sure that you should avoid scrubbing of area.

I hope it helps.

With regards,

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sanjay Kumar Kanodia

Dermatologist

Practicing since :2002

Answered : 4165 Questions

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What Causes Foamy Stool And Perianal Dermatitis

Brief Answer: Diagnosis of peri anal dermatitis. suggestions as below. Detailed Answer: Hello, Welcome and thanks for posting your query to the forum. I can understand your concern for the peri anal rash in your little baby. I have diligently analyzed the complete query along with the day 1, 2 and 3 pictures. After analyzing the complete condition let me reassure you first that your doctor is correct in his/her diagnosis of peri anal dermatitis. If you can observe the affected area then can make out that there is rim of redness which is progressively increasing. There is slight vasculature in the day 3 pictures along with redness. All these features favors the peri anal dermatitis. In order to take care of the condition I suggest you to kindly follow the suggestions for next 24 hours : - Take XXXXXXX Warm water and clean the area for two minutes. Take a cotton ball and clean the area gently. Mop it gently with tissue paper every time after cleaning and otherwise a better so in 1 to 2 hours. - Do it for 4 to 5 times. You can clean the area every time the baby is passing the stool. - If it is possible to not to apply diaper then would be best of policy for next 24 hours. Rather than using a diaper, a plane cotton cloth would be better. I know this sounds bit difficult but would be a better policy at this time. As the peri anal area is already moist and diapers make it more worsened. Do not apply any medication for next 24 hours. Let it heal by itself. If a better lot all you want to apply the medications then use a pea size amount for palm size area and that too should not be visible to the naked eye. But preferably avoid medication. I additionally suggest you to give zinc syrup. You can talk to the treating doctor for the same. Many times continuous diarrhoea causes zinc depletion and accordingly more chances of such kind of rash. I hope all this information will help you. My best wishes for speedy recovery. With regards,