Dávalos-Tanaka M, Venegas-Andrade A, Velasco-Hidalgo L, Ramírez-Ristori AG, Durán-McKinster C

Language: Spanish
References: 8
Page: 23-28
PDF size: 242.78 Kb.

ABSTRACT

Introduction: Diaper rash dermatosis is frequent in infants. There are multiple causes: inflammatory, infectious, metabolic, autoimmune, traumatic, due to a tumor or sexual abuse. The recognition of these entities by the primary care physician is fundamental for its correct diagnosis.
Clinical case: 14 month old female infant, with a diaper rash dermatitis since 9 months of age, treated with multiple topical drugs without improvement. She was referred to our clinic due to a high suspicion of sexual abuse by household aggressor, with lesions on the vulva and perianal region. These consisted on multiple irregular ill-defined erythematous and friable ulcers, axillar and inguinal fissures, adenomegalies and petechiae. Our presumptive diagnosis was a Langerhans Cell Histiocytosis and was confirmed with skin biopsy, blood test and x-rays, excluding sexual abuse. She was treated according to the guidelines of the Histiocyte Society, with systemic steroid and vinblastine, with favorable results.
Conclusion: Langerhans Cell Histiocytosis commonly affects the diaper area. The lesions that appear in this area, that are ulcerated and progressive and do not improve with conventional treatment should be evaluated to rule out other diseases. Sexual abuse is a diagnosis that has to be well substantiated before starting legal action, as it causes damage to the family.

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