1 week to 4 weeks (First 6 days in NICU): January 2019
At birth, the only signs of abnormality were two small plaques on the forehead.
Skin injuries on right arm and other limbs following use of tourniquet.
Prior to definitive diagnosis, awaiting transfer to Zurich in humidified incubator.
Management of multiple wounds with Octenisept gel and Mepilex transfer
Early hyperkeratosis on knee and lower leg No hyperkeratosis evident on soles of feet
Wounds on face caused by Venflon on hand
Wounds on hand caused by Venflon
1 week to 4 weeks (First 6 days in NICU): January 2019
Extensive peeling, dryness, and erythema No scaling evident. Skin on back dry, cracking in places, and some small bullae
Any attempts to remove large patches of peeling skin result in skin trauma.
Cracked and peeling skin on Left inner arm, most prominent in flexures and folds.
2 weeks later, skin much improved Mild erythema, but skin intact on back Much improved but recent, healing bullae Chest, belly, arms, and face appear normal
2 months: March 2019
Reduction in erythema and bullae following naked time and no skinnies
Central small blister, external red ring a possible local reaction to Mepilex Transfer
Small cluster of water blisters on lower back, probable cause: moisture and friction
Wound 1 day after de-roofing water blister cluster on lower back
Reduction in erythema and bullae following naked time/less diaper use
Improvement seen in diaper zone following naked time/less diaper use
Formation of dense, diamond, yellow scale around the neck
Start of small, dense, yellow scale in elbow crease, and dry, flaky skin on upper arm
2 months: March 2019
Pressure points evident in the evening after 2 x 3 hours in the car
Some
The
Heat and friction injury on left thigh following afternoon with SPIPED nurse*
2 days after 6 hours in car seat, and 1 day after afternoon with SPIPED nurse, multiple wounds evident and multiplying
Multiple lesions covering hips, thighs, buttocks, groin, lower legs, and arms Large wounds from friction, small blisters appearing spontaneously. Advice sought.
Further wounds associated with Mepilex Transfer & Flaminal Hydro Dressings used to cover multiple lesions, wounds appear around edge of the dressing.
seat
linear scaling evident along left elbow creases
Left shoulder, posterior armpit crease, and upper flank with mild scaling
evening after 2 x 3 hours in car seat, small blisters on buttocks and right hip
3 months: April 2019
Left lower leg, large wound caused by attempts to fit tubular bandage over calf
Linear, white cornification in knee creases, & fine, round, yellow scale in thigh creases
Extensive and dense, linear, yellow cornification on whole of right arm
Sores on bottom are not typical of bullae. Irregular edges suggest fungal infection.
Diaper bullae reduced by Oxyplastine, but increased dryness, scale & cracking
Reduction in Oxyplastine led to another fungal infection treated with Imazol cream
Reduction in large scale, cracks, and dryness achieved with Bepanthen
Erythema and dense, yellow scale in left armpit.
Dense, round, yellow scaling on whole of right leg; thickest part on lower shin
Dense, linear, yellow scale on whole of right arm; thickest part in elbow crease
Patches of scale and erythema on posterior left thigh. Knee crease prone to blistering
Dense, round, yellow/brown scaling on both elbows (Left elbow pictured)
Fine, round, white scaling on scalp, hairline, and lateral aspects of face
Dense, diamond, yellow cornification around the “collar” of the neck
Round, yellow scaling covering the whole back with intermittent blistering/erythema.
Skin very fragile: small blisters caused by finger-point contact on lower leg
5 months: June 2019
Round, flat, yellow scale on back improved after only 3 days bi-daily Aveeno Dermexa use
Dense, linear, yellow scaling and erythema in armpit improved
Dense, linear, yellow scale in elbow crease reduced
Dryness and build-up of yellow scale on wrist creases improved
5 months: June 2019
Erythema & inflammation evident on legs 2 hours after heat intolerance episode
Inflammation, blistering and exuding wounds 7 hrs after heat intolerance episode
Raw areas beginning to heal 12 hours after removing the roof of friction blisters
Epidermis healing well 36 hours after removing the roof of friction blisters
Blistering within diaper zone and evidence of fungal infection in right hip crease
Right hip crease after 2 applications of Imazol fungicide cream
Right hip crease after 3 days of Imazol fungicide cream application 3 times daily
Erythema due to friction from car seat stroller, acquired during hospital apt.
6 months: July 2019
Appearance of face due to overheating Erythema and inflammation on both legs 3 hours after overheating episode
12 hours after heat exposure, fluid present beneath epidermis.
24 hours after heat exposure, mild friction resulted in denuded skin.
Large blister formed under thick skin after use of Diprobase ointment on a humid day
Left elbow crease following removal of blister roof
Rupture/Cracking of ridges between lines of cornification on left elbow crease.
Posterior thigh showing healing blister and cracking of ridges in knee crease
6 months: July 2019
Dense, fine, yellow scale around collar of neck. Cycle of build-up followed by slough.
Build-up and sloughing scale in elbow crease
Patches of scale adjacent to denuded skin caused by attempts to remove scale.
Attempts to remove thick white/yellow scale build-up on thigh results in injury
Fluid under thickened epidermis on hips, caused by diaper friction in hot weather
Exudating wound on left hip following removal of blister roof
Increasing wound on left hip caused by moisture and friction within diaper
Bilateral hip wounds healing via daily naked time during 38 degree heat
7 months: August 2019
Widespread skin sloughing in armpit crease, and along length of arm.
Skin sloughing and patches of erythema on belly. Attempts to remove skin cause injury
Very thick and tight skin on right thigh, with cracking and redness in creases/folds
Knee crease and posterior right thigh. Skin cracked in knee crease, and skin folds
Sloughing skin on inner arm and very dry scale in elbow crease.
Linear, silvery scale on back of left hand & wrist.
Thick, patterned, yellow scale with large fissure on left lateral neck
Very dense, and thick, patterned scale on posterior neck, focused around collar only
7 months: August 2019
Blisters on left lower leg caused by Tiger mosquito bites
Extensive skin injury cause by scratching at mosquito bites during the night
Wound 6 hrs after treatment with Mepilex Transfer & Fucidin ointment.
Wound on day 2, scratching affects more layers of dermis than blisters.
Blister on right forearm caused by Tiger mosquito bite
Excessive skin dryness causing cracks in linear scale on heals
Dense & slightly moist thickened skin/scale in right armpit. Manual removal possible.
Very thick & tight skin on right thigh, any attempts to remove cause tears/bleeding.
8 months: September 2019
Wound on left hip originating from crack in thick skin becoming moist under diaper tab
Left-posterior armpit crease showing dense, linear, white cornification
Blister injury to left ankle caused by a seam at the edge of a new stroller seat
Skin injury/erythema resulting from cracked thick skin on upper right thigh
Suspected bacterial infection on left lower leg following scratched mosquito bites
Left arm image indicating scale at elbow crease, widespread sloughing, and blisters
Left thigh with thick skin at groin crease, injury due to mosquito bite, and scratching
Right thigh with generalised sloughing and dryness, & injuries caused by scratching
ect placement of skinnies led to ound on foot Mosquito bite reaction
Wound caused by scratching, cause of pruritus unknown
