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New Port Richey, FL 34655
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Posts for category: Dr Sheridan Hernandez

By Sheridan Hernandez MD
February 12, 2018
Tags: Atopic Dermatitis  

Hello, Dr. Hernandez here.

 

Many children have atopic dermatitis (AD) also known as eczema. I thought today I would I share some of our latest understanding and knowledge of AD.

 

AD affects 10-20% of all children and 1-3 % of adults. It can range from a mild condition which is generally quite easily managed with creams, ointments, oils and lubricants, to a very severe condition which causes severe breakdown of the skin barrier with associated unbearable itching. The severe form of eczema can be quite debilitating, causes a lot suffering and, unfortunately, can be very difficult to control.

 

AD has increased two to threefold in the last three decades in industrialized countries, but this increase has not been found in areas that are primarily rural and agricultural. Both genetic and environmental factors are felt to play a critical role in the expression of AD. For example, from a genetic point of view, a child of parents, both of whom had an atopic condition such as asthma, allergic rhinitis (hay fever etc.) or eczema, is 5 times more likely to have early onset, childhood eczema, than a child of parents neither of which had an atopic condition. From the environmental point of view, children whose mothers were exposed during pregnancy to farm animals in particular, but also dogs and cats, were less likely to develop early childhood AD, than the children of moms who had no such exposure. Also children who are fed yogurt with live active cultures in the first year of life have a decreased likelihood of developing AD (PASTURE study- Protection against allergy study in rural environments).

 

Childhood AD has been broken down into 3 types, early transient means the condition starts before age 2 but resolves by age 4, early persistent which means it starts before age 2 and lasts at least to age 6 (these children are much more likely to have AD that lasts to adulthood) and late onset AD that starts after age 2. Children with the early onset types are at increased risk of developing asthma by age 6 and are also at increased risk of developing or having food allergies. Children with early persistent AD are at the highest risk for both respiratory and food alleges.

 

Unfortunately, early persistent AD can be very difficult to manage. Topical corticosteroids are the most widely used treatment, but because of side effects of long term regular use they are not really recommended for maintenance therapy. Ceramide lipid creams such as EpiCeram can be very effective, as can calcineurin inhibitors such as tacromlimus and pimecromlimus. UV light therapy can also be effective.

 

Although there is no magic bullet answer out there to cure eczema, I think it is important for the parents of children with more severe AD or eczema to be aware of the increased risk their children have for developing asthma and allergies. They can then be proactive and observe their kids for signs of allergy and asthma and seek appropriate care. Furthermore, I wanted parents to be aware that there are some new treatments emerging that have been found to be helpful in treating this very troublesome condition.

 

As always, it is my honor and privilege to take care of your beautiful kids. Peace

 

Dr. Hernandez

By Dr. Sheridan Hernandez
July 23, 2015

Hi Parents.

Today I'm going to talk about babies and their pooping. Pooping, it seems to me, is the biggest concern of parents of newborns and infants. So here's some info to hopefully guide and reassure you.

Some babies poop several times a day, little liquid toots with poop usually. Some babies only poop every few days and, usually for exclusively breast fed babies, sometimes only about once a week. When these less frequent poopers do finally unload, it is usually a huge explosion of stool and requires quite the clean up 😁. This is normal. If your baby is happy and feeding well, passing gas (gas is fine, all babies are quite gassy), not vomiting, his/her tummy is not hard and bloated, then do not be alarmed by 6 poops a day or one poop in 6 days. On the other hand, if your baby is crying inconsolably, not feeding, bloated and not passing gas and/or vomiting, then it may be a serious medical emergency. In this case the baby should be evaluated ASAP.

Baby poop can be liquidy or pasty. It can be yellow, orange, green (dark to light) and various shades of brown. After the first few days of life it should not be black. Neither should baby poop be white (especially if your baby is jaundiced) or have any thing that looks like blood. So if it's black, bloody or white and baby looks yellow, call and make an appointment to have your baby seen. There is an app called poopMD that shows pictures of different types of normal baby poop.

Okay, hope this helps.

Dr. Sherry Hernandez



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