娃5岁,这是那种bacteria

hannah04
楼主 (北美华人网)
看图,娃长期以来受那个bacteria的折磨,看specialist也看不好,现在大点了还好一些,小时候情况还要糟糕,版上有没有遇到过,看看这个该怎么搞,天天涂lotion,要求一天两次
casperduo
看不见图
hannah04
看上图 这个耳朵永远都是烂的
IsabellaQ
湿疹?
casperduo
不是细菌,是典型的atopic eczema behind the earlobe,ulcer是经典症状,脖子后面也是atopic eczema。找儿医开强力固醇激素擦,平时注意涂保湿乳。孩子平时有没有鼻炎或者哮喘?
candyland
好奇娃已经五岁了你还搞不清楚什么bacteria,叫什么?
hannah04
回复 7楼candyland的帖子
当然 医生说是eczema 湿疹,可我就是觉得是某种菌
hannah04
回复 6楼casperduo的帖子
谢谢 家里已经一堆激素好lotion 通常痒到受不了了就上激素 否则lotion 说是eczema 可我不信 就是认为是厉害的bacteria 😂
casperduo
回复 6楼casperduo的帖子
谢谢 家里已经一堆激素好lotion 通常痒到受不了了就上激素 否则lotion 说是eczema 可我不信 就是认为是厉害的bacteria 😂
hannah04 发表于 2021-09-11 02:34

激素要一直擦,擦到好了之后,再用lotion维持。你间歇的擦激素肯定不行。擦激素的指标不是痒不痒,是肌肤变正常。激素擦擦停停就不灵了。
hannah04
回复 6楼casperduo的帖子
没有鼻炎 哮喘小时候有一点点点 现在基本没有
hannah04
回复 6楼casperduo的帖子
这个东西怎么得的?那么顽固 我很绝望 娃小时候 我都直接给我妈带 晚上也和我妈睡 实在难带的很 😂
hannah04
回复 10楼casperduo的帖子
怪不得 原来如此 我嫌弃那个激素不好 所以一般能不用就不用 除非痒的不行
casperduo
回复 10楼casperduo的帖子
怪不得 原来如此 我嫌弃那个激素不好 所以一般能不用就不用 除非痒的不行
hannah04 发表于 2021-09-11 02:42

激素要一直用到完全好才能停,之后每天lotion维持。你要问医生正确额用法啊。
hannah04
回复 14楼casperduo的帖子
我一直对激素很排斥 所以娃搞到现在也没好 😭
d
darkcaramel
激素lotion先涂着,和自身免疫系统有关系,大了就好了。
SheldonCooper
是湿疹,上激素,好了之后厚厚的balm维持,lotion太稀了没什么用。 另外你有什么理由觉得医生说的就是不对?看到后面你说娃小时候都是丢给你妈带我就明白了
jedi2006
回复 6楼casperduo的帖子
谢谢 家里已经一堆激素好lotion 通常痒到受不了了就上激素 否则lotion 说是eczema 可我不信 就是认为是厉害的bacteria 😂
hannah04 发表于 2021-09-11 02:34

医生说啥不信 华人上几个网友说的 就信了?还有对激素的误解 真是耽误了娃。
h
hhxx89
孩子太难带了 晚上都给老人带 服了
cheeryinmay
我特别不理解为什么中国人好多迷之不信医生(还有其他专业人士),信自己瞎琢磨和道听途说的,敢情人家受好多年的教育、训练还有经验都是摆设?一个医生说的可能不对,那可以seek for a second opinion再看一个医生,就比较有把握了。 吐槽完提供点建设性意见,我娃是普通轻度湿疹,没有用特别厚的balm,但普通的balm/cream用下来感觉mustela的湿疹专用的balm最好用,cerave我不喜欢,eucerin还行
sandyud
mm除了耳朵那里脖子后面看着像皴裂的地方也是湿疹。需要激素加长效保湿。
casperduo
回复 10楼casperduo的帖子
怪不得 原来如此 我嫌弃那个激素不好 所以一般能不用就不用 除非痒的不行
hannah04 发表于 2021-09-11 02:42

激素确实有副作用,前提是长期、大量(口服)的情况下。皮肤上用的激素很少量啦,不用担心。但是你擦完激素,要记得洗手。
菠菜东
我的天,这也太严重了吧。看医生化验了吗?如果排除别的情况确诊湿疹的话该上激素就上,不能因为你自己愚昧害了孩子啊。等皮肤恢复正常之后,每天起码早晚两次lotion,特别是洗完澡之后立马擦效果最好,bless小朋友快快好。
咸鱼红烧肉
拖到这么严重,就因为不信医生?迷之觉得激素不好?娃太可怜了。你自己把娃丢给老人也就算了,平时也不和身边亲自带娃的父母交流吗?用可的松或者医生开的更强效的激素膏的都大有人在啊。
s
springbee
如果就脖子上有身上没有,也有可能是对枕头过敏引起的湿疹。去掉过敏源同时上激素,激素没有那么可怕。
redder
如果实在忌讳激素,跟皮肤科医生说不想用,让他开别的,说不在乎钱,保险不包也没关系,一般这样他会大笔一挥给你开个出来。一般医生给激素类药也是因为便宜保险包。
casperduo
如果实在忌讳激素,跟皮肤科医生说不想用,让他开别的,说不在乎钱,保险不包也没关系,一般这样他会大笔一挥给你开个出来。一般医生给激素类药也是因为便宜保险包。
redder 发表于 2021-09-11 17:22

拜托,湿疹的唯一治疗就是类固醇激素,和价格无关。
Icd
这种问题当然要听医生的。人家医生也是正正规规的专业人士。不相信医生的难道相信路人说的话吗?这么严重的湿疹就要上激素涂。娃耳朵都烂成这样了,还不上药,这是心疼娃还是还是害娃?不是细菌性感染的都要被弄成感染了。药膏里那么点少的不能再少的激素,还又不吃到肚子里,根本不会怎么样。做妈妈的不要一谈激素就色变。
sweatyarmpit007
回复 27楼casperduo的帖子
Topical tacrolimus is not a steroid.
casperduo
回复 27楼casperduo的帖子
Topical tacrolimus is not a steroid.
sweatyarmpit007 发表于 2021-09-11 22:09

Tacrolimus only used in whose eczema has not responded to steroids.
bilibala
我娃湿疹抓破了起了几个疱疹,医生戳破了一个做了culture test,测出了bacteria, 开了抗生素药膏就好了。但是我看你娃这样就是干燥型湿疹
sweatyarmpit007
回复 30楼casperduo的帖子
You said steroid is the only topical treatment for eczema. I said topical tacro is not a steroid. It can be used in moderate eczema.if there are steroid spring concerns. Pediatric dermatology should go consulted on these management decisions.
casperduo
回复 30楼casperduo的帖子
You said steroid is the only topical treatment for eczema. I said topical tacro is not a steroid. It can be used in moderate eczema.if there are steroid spring concerns. Pediatric dermatology should go consulted on these management decisions.

sweatyarmpit007 发表于 2021-09-12 16:08

Tacrolimus is recommended as a second-line treatment for persons with moderate to severe atopic dermatitis and who are at risk of atrophy from topical corticosteroids. -- AAFP 2012.
redder
Tacrolimus is recommended as a second-line treatment for persons with moderate to severe atopic dermatitis and who are at risk of atrophy from topical corticosteroids. -- AAFP 2012.
casperduo 发表于 2021-09-12 16:33

这有什么好争辩的?我自己的经历就是开这药没那么难开,医生给开,而且好用。至于湿疹到什么程度这个本来就是界限不明确,除非特别轻或者特别严重。做父母的做好功课,跟医生谈去。
casperduo
这有什么好争辩的?我自己的经历就是开这药没那么难开,医生给开,而且好用。至于湿疹到什么程度这个本来就是界限不明确,除非特别轻或者特别严重。做父母的做好功课,跟医生谈去。
redder 发表于 2021-09-12 16:46

你连我们讨论的是什么药都不清楚吧,不是学医的就不要强行发表意见了。
redder
你连我们讨论的是什么药都不清楚吧,不是学医的就不要强行发表意见了。
casperduo 发表于 2021-09-12 17:11

你学了个一知半解也是牛逼的很。。。。
casperduo
你学了个一知半解也是牛逼的很。。。。
redder 发表于 2021-09-12 17:24

你说医生因为steroids便宜,所以才开激素,就暴露了你的无知。医学是evidence based science,不是price based。自己不懂的领域就少开口,否则丢脸。
redder
你说医生因为steroids便宜,所以才开激素,就暴露了你的无知。医学是evidence based science,不是price based。自己不懂的领域就少开口,否则丢脸。
casperduo 发表于 2021-09-12 17:40

你不用跟我矫情这个,这是我的医生他自己说的,因为太贵,他给有的家长开,人不要,觉得保险不包贵。我的医生top医学院毕业,top医院实习医出来的。你牛叉,牛的看看你自己的第一个回帖,不然那个妹妹也不会出来反驳你。。。你自己丢了脸,自己在矫情,我回帖就是告诉楼主妹妹有其他选择。
casperduo
你不用跟我矫情这个,这是我的医生他自己说的,因为太贵,他给有的家长开,人不要,觉得保险不包贵。我的医生top医学院毕业,top医院实习医出来的。你牛叉,牛的看看你自己的第一个回帖,不然那个妹妹也不会出来反驳你。。。你自己丢了脸,自己在矫情,我回帖就是告诉楼主妹妹有其他选择。
redder 发表于 2021-09-12 18:40

不明白你们为什么放着主流first line 的药物不用,非要先用second line 治疗的药物,同样是辅助治疗的光疗你们又不提。
再top的医学院医生这种常见病也是按照guideline治疗。
只有下等人,回帖才会攻击别人。
你还是相信中医,继续吃逍遥丸和乳安片吧。

sweatyarmpit007
回复 33楼casperduo的帖子
I agree. It is second line treatment. As a PCP, i do not prescribe topical tacrolimus. I defer to dermatology.
I am merely saying that steroid is not the only topical option. There are steroid sparing options out there. I have two friends from med school who are in fact fellowship trained pediatric dermatologist and my child has eczema. I have looked into this very recently.

sweatyarmpit007
回复 38楼redder的帖子
Of course, dermatologists are not scared of steroids. They prescribe fairly long courses without qualm. However, i don't think it is unreasonable for parents to bring up their concern with their doctor. Parents should obviously be educated and be compliant with proper steroid use and care for eczema first, but i do want people to know that there are topical steroid sparing treatments out there.



sweatyarmpit007
回复 39楼casperduo的帖子
OP is not using the topical steroid correctly. Many already corrected her in this regard. So i didnt comment on it.
candyland
回复 40楼sweatyarmpit007的帖子
There is a question I have been pondering for a long time, and I hope you don’t mind me asking. Why do most physicians automatically refer eczema patients to dermatology and not GI? Both if my children had severe, weeping, bleeding eczema since they were infants. Tube after tube of various creams only covered it up like a bandaid. We were lucky enough to come across a pediatrician who pointed out most eczema cases are due to food intolerances. Once we eliminated the food triggers from their diet, they skins cleared up immediately. I have encountered other parents who have had same experiences. Is it simply because there is no reference to any relationship between eczema and GI in medical teachings? I just really wish more parents know about this rather than having to see their child suffer.
w
whattoexpect
回复 40楼sweatyarmpit007的帖子
There is a question I have been pondering for a long time, and I hope you don’t mind me asking. Why do most physicians automatically refer eczema patients to dermatology and not GI? Both if my children had severe, weeping, bleeding eczema since they were infants. Tube after tube of various creams only covered it up like a bandaid. We were lucky enough to come across a pediatrician who pointed out most eczema cases are due to food intolerances. Once we eliminated the food triggers from their diet, they skins cleared up immediately. I have encountered other parents who have had same experiences. Is it simply because there is no reference to any relationship between eczema and GI in medical teachings? I just really wish more parents know about this rather than having to see their child suffer.
candyland 发表于 2021-09-13 00:30

你来这里问,很多妈妈都知道湿疹跟食物过敏食物不耐受有关的吧
ddswallow
我们家二宝也是湿疹患者,华人上姐妹见多识广,帮助我们这些备受折磨的宝贝和宝妈。
sweatyarmpit007
回复 43楼candyland的帖子
Well, often, people have a little eczema, like my kids. They use a little steroid here and there. It is kind of a pain but nothing terrible. That's just a PCP problem. I do advise families to try to to see if there are any food or environmental triggers in their lives. Kids are often have asthma and food allergies as well. It is called the atopic triad. Dermatologist are aware of the rationship with other allergic conditions and often refer to allergists for further testing. The problem with broad food allergy testing is that ... It is kind of chaotic. Food allergy testing is not really a yes or no result.
sweatyarmpit007
回复 43楼candyland的帖子
我感觉还好,我以为一般大夫都会跟患者提起这个? 大部分eczema比较轻。保湿大一点就好了。 比较严重的我自己也会跟家长说注意trigger. Food allergy testing 大家喜欢什么都test但是那个result 不是很容易interpret.
candyland
回复 46楼sweatyarmpit007的帖子
I see. Thank you very much for the explanation. Yes, food intolerances do not show up on allergy tests, so the concept is sometimes too abstract for most parents.
candyland
你来这里问,很多妈妈都知道湿疹跟食物过敏食物不耐受有关的吧
whattoexpect 发表于 2021-09-14 03:24

起码我认识的大部分都不知道。不然也不会三不五时就有人开贴求助孩子湿疹的事。
ashesofrose
楼主孩子的症状和我家娃一摸一样,也是耳朵和脖子。 就是湿疹啊。 你这种这么严重已经要用比较强的激素比如倍他米松了。 坚持抹几天,皮肤恢复了就大量保湿。 如果激素停了以后还复发,就查过敏源。我们做了以下措施: 1.查过敏源,食物和环境的都要做。我家娃被发现对dust mite过敏,家里做了很多除螨的工作。 2.保持皮肤清洁,用温和的沐浴液洗澡。 每天大量保湿霜往湿疹的地方抹(一天摸3-4次)我家用的是凡士林,cerave和v a ni cream 3.勤换衣物 4.隔三差五泡DEAD SEA SALT Bath。海盐有杀菌作用。 5.注意防晒,湿疹的皮肤用不了防晒霜,太刺激了。穿防晒衣物戴防晒帽 折腾了几年,现在终于压下去了,基本不用激素了。 反正是个漫长的过程。