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AAP National Conference: Pediatric dermatologist reviewed diagnosis, treatment of rashes :

October 22, 2016

Attendees of an Audience Response Session titled “Itchy Stuff: Cutaneous Infections and Infestations tested their acumen in diagnosing and treating skin infections.

Renee Howard, M.D., director of dermatology, UCSF Benioff Children’s Hospital Oakland, discussed staph infections and coxsackie viral rashes.

“Staph is very common, especially in eczema patients,” she said. “Coxsackie viral rashes come through the community as epidemics episodically.”

Dr. Howard also showed photos like the one below of eczema coxsackium as she reviewed a good clinical approach to rashes.

“Eczema coxsackium can be very severe but ultimately heals without scarring, and patients don’t have any systemic complications most of the time,” said Dr. Howard, who also is an associate professor of dermatology, UCSF.

When making a diagnosis, it’s important to rule out bacterial infections like staph and strep, varicella, and herpes simplex or eczema herpeticum, she said. When in doubt, send cultures for testing.

She also helped attendees differentiate commonly confused conditions. For example, staph infections can be subtle and may be confused with acne or ingrown hairs.

Treatments options were reviewed, and problems with resistance were addressed.

“Methicillin-resistant staph is a huge problem,” Dr. Howard said. “We are using more bleach baths to treat milder infections and prevent recurrence.”

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