What Caused Eczema to Flare in This Toddler?

THE CASE: This 20-month-old patient with eczema has had a flare during the past week.

(Answer and discussion on next page.)

Bacterial infection is the correct answer.

DISCUSSION: This child with the eczema flare has a bacterial infection. A culture of a specimen from the blistery, impetiginous rash grew Staphylococcus aureus. A reaction to soap or bubble bath generally causes a more widespread rash. The distribution does not resemble that of an eruption caused by new diapers. Fungal infection was considered in the differential but was ruled out by the positive bacterial culture. 

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Case and image courtesy of David L. Kaplan, MD, University of Missouri Kansas City, University of Kansas.