My two-year-old daughter has a red rim around her lips and her lips are constantly extremely dry and scaly. In addition, she has diaper rash with a clearly defined shape that is slightly raised on the edges. She also has two round red raised, scaly spots on her trunk near the diaper rash. She has had this condition for four months, and no amount of antifungal creams and steroid creams got rid of it. What could this be?
- H.A., London
Veteran Jerusalem dermatologist Dr. Julian Schamroth replies:
Dry and scaly lips is called cheilitis and has a variety of causes. In young children, it is often triggered by chronic lip-licking, persistent wetness from saliva under a pacifier or possibly an allergy to the latex contained within the pacifier itself. Other possible diagnoses include allergies to toothpaste, lipstick (in adults), allergies to foods, fungal infections, dermatitis (eczema), and "allergy" to the sun (actinic cheilitis).
Your use of anti-fungal creams excludes a diagnosis of a fungal infection, but the failure to respond to a cortisone cream does not exclude an allergy or dermatitis. On sensitive skin such as the lips and around the mouth, great care should be taken to use mild, non-fluorinated cortisone creams. Failure to do so might exacerbate the condition. If the cheilitis is caused by an allergy and lip-licking, then the aggravating factor must be removed.
As for the diaper rash, an important distinction should be made as to the location of the rash: If the diaper rash is in the skin folds or creases, it is most likely to be a fungal or yeast infection. If the diaper rash is on the convex surfaces, then it is probably a dermatitis due to persistent contact with the urine, or even an allergy to the disposable diaper; many diapers have chemicals that can be irritants. Diaper rashes should also be treated with mild, non-fluorinated cortisone creams, barrier creams (to block contact of the skin with the urine or diaper) and frequent airing of the affected area.
The reader is advised to see a dermatologist who should be able to make a more accurate diagnosis and suggest the best method of treatment.
I am a 75-year-old woman. I have recently been falling in the streets, which are hilly. However, I also collapsed in a store. With no apparent reason, my legs just go under my body, and I can't walk. I have Type 2 diabetes and also take prednisone for asthma. Please advise, as this has never happened to me before and is very frightening.
- M.F., Ra'anana
Prof. A. Mark Clarfield, chief of geriatrics at Soroka University Medical Center in Beersheba, comments:
Falls in older people are unfortunately quite common and can cause fractures, head trauma and other damage. There are multiple causes for falls, some quite simple to diagnose and to treat. However, when they are - as you describe - a new event, this often points to an acute illness and/or a side effect of medication.
For example, either a high or low blood sugar (caused by diabetes treatment or an underlying infection), or a side effect from the prednisone or a "silent" heart attack often seen in diabetics, can all cause such a situation.
In any case, given that the story points to an acute problem, you must see your doctor immediately or, failing that, visit a hospital emergency room.
Judy Siegel-Itzkovich adds:
Reader Joan Weinberg responded to the previous Rx for Readers column about the "incurable" condition called tinnitus that causes constant ringing in the ears. Weinberg relates:
I suffered from tinnitus. I heard that eating 1/4 cup of sunflower seeds will get rid of the the problem within a week or so. It did so in three days. I passed the word along to a colleague who suffered from tinnitus for several years. He pooh-poohed the idea, but when I pointed out that he had nothing to lose, he tried it and the ringing in his ears was gone. Several months ago, I had a plantar's wart that became really painful because I was putting off surgery. Then I remembered hearing something about a natural cure. I consulted the Internet and sure enough - banana peels! I was skeptical and certainly felt stupid taping a piece of peel to my foot, but having had success with the sunflower seeds I thought I'd give it a try. The wart was gone in three weeks.
While we are wary of anecdotal medical "cures," we invite readers to try sunflower seeds for tinnitus and banana peels for plantar warts. Tell us if they worked for you.
Rx For Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx For Readers, the Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to firstname.lastname@example.org, giving your initials, age and residence.