Case Study: 5-Month-Old with a Chronic Rash. What’s Your Next Step?

Learning Opportunities: Clinical Case #1

🚨This is a real case🚨

Meet our patient, a 5-month-old male with a persistent rash that has puzzled his caregivers for over five weeks.

Here’s your first glimpse into this case:

Now that you’ve met your patient, take a moment to consider the key aspects of the case.

Ready for the next step?

This part will ensure a thorough approach and help guide you toward the best possible outcome for the patient.

So now, think about your differential diagnosis, write down the questions you would ask the parents, and create a management plan based on what you have considered so far:

At this point, you’ve gathered the key details of the case.

It’s time to be more specific: how are you treating? What else do you think would be best to evaluate?

Consider your options carefully and think about the most appropriate course of action.

Choose one (or more) of the following options and explain your reasoning below:

Now that we've walked through the case and considered the possible options, let’s take a look at the final diagnosis and the management plan that was implemented.

☝️Remember: This is a real case, so everything you’re about to read actually happened.

Drum roll, please…🥁🥁🥁

Pearls from this Case:

1. Early AD often improves with age, but monitor for possible asthma development

2. Barrier repair is just as important as anti-inflammatory treatment

3. Always educate on tapering steroids after the skin clears to target subclinical inflammation

4. Avoid systemic antibiotics unless secondary infection is evident (honey-colored crusting, excoriations)

5. If the child were older, consider:

• Desonide 0.05%

• Hydrocortisone valerate 0.2% (Westcort)

• Calcineurin inhibitors if over 2 years (Tacrolimus, Pimecrolimus)

  Would you have handled this case differently?

  
  We’d love to hear how you’d approach this case!