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Suggest Treatment For Skin Infection Near Urethra

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Posted on Tue, 6 Oct 2015
Question: Hi! Im a little concerned about my 2.5 year old daughter's labia region. It seems everytime I change her diaper, when I go to wipe between the labia, she tenses up and screams like she's in pain. I don't often seperate her labia because it's such a fight, but I always run wipes through it mulitple times (especially if she's pooped) to make sure it is clean in there. Anyway today while I was wiping a pee diaper, she started to cry when I wiped there. I decided to look between her labia and it looks very red, and at the tip of where it seems the urithra should be its like there's a white mass, node or something? Looks like a piece of skin? I tried to wipe it off gently but that seem to hurt her more so I stopped. Its at like the very bottom near the urethra, but on the clitorious too. It seemed hard when I tried to wipe it. She doesn't seem to be in pain when shes going to the bathroom.. But this white thing is really concerning to me. I'm making a doctors appointment with her pedi first thing monday, but since it is the weekend and im worried i thought I would ask here. Any ideas as to what it could be? I don't know that I should post a picture since it's her private area, so description is all I can do.
doctor
Answered by Dr. Sumanth Amperayani (2 hours later)
Brief Answer:
Could be a fungal infection or skin desquamation remnants

Detailed Answer:
Hi.....as I was going through your question I thought of asking you to upload a picture, but at the end you had mentioned that you cannot do so. I understand your concern.

As you have clearly mentioned that she's not crying while urinating it cannot be a urinary infection.

By what you quote I feel that the possibilities are -

1. Fungal infection.
2. Skin desquamation remnants accumulating there.
3. Vaginal synechiae.

None of them is an emergency. Do not worry. But do not try to remove or wipe by force.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani (2 hours later)
Do you think it could be a yeast infection? I just bathed her and looked inside her labia folds again (she sure didnt want me too poor thing) and i noticed another smaller white dot. I took a wipe and gently rubbed and this came right off. It was like a ball of cottage cheese. That first white mass i mentioned seems globbed on there like its stuck so i dont dare rub and irritate it more.. And i had no clue what it was cause it looked isolated. I guess i never thought of a yeast infection cause she had a few as a small baby and those ones caused a horrible red rash with satliete bumps.. She is a little red on her bum with only a few tiny red dots elsewhere, but no crazy rash. Is it possible to have a yeast infection without a crazy noticible diaper rash to go with it?

I also should note, she had an issue with a bug bite and her eyelid and was on a heavy dose of clyndimiacin for 10 days orally. Then she has been on a different eye cream which i believe is either antibiotic or steroid cream for about a month now. Ive read that if you take a lot of antibiotics itcan make yeast infections worse. Could that be contributing at all?
doctor
Answered by Dr. Sumanth Amperayani (56 minutes later)
Brief Answer:
It could be a yeast infection

Detailed Answer:
Hi....coming to your queries directly -

1. Yes, it could be yeast infection. It is possible to have a fungal infection without much rash.

2. I agree about antibiotics and fungal predisposition. But, Antibiotics for a week at proper dose and indication are unlikely to cause yeast infection like this elsewhere in the body. This happens only after prolonged intravenous antibiotics that too after ICU stay etc.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani (33 hours later)
Okay so this morning while I changed her diaper, i was able to get what i thought was a white piece of skin out of her urithera. It is simply a mushy ball of white stuff... Kinda cottage cheese like? Im thinking if its not a yeast infection, could it be leftover A&D cream that got stuck in between there? Now that its gone shes just a little red and a tiny bit swollen. Im going to keep a close eye to see if any more of this white stuff shows up.

If it doesnt, do you think it was possibly just a piece of debris caught there that was causing pain and a little swelling?
doctor
Answered by Dr. Sumanth Amperayani (58 minutes later)
Brief Answer:
Looks like skin slough rather than cream

Detailed Answer:
Hi....I have just seen the image and gone through your explanation. This looks more like skin slough or debris than cream.

By the way what happened to the Dr appointment today. You told you will be seeing a pediatrician today.

If she's active do not worry about it as of now.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani (2 hours later)
What is skin slough and how do i prevent this from happening in the future?

So when i orignially asked my first question it was over the weekend and her doctor's office was closed. My plan was to call today and make and appointment. Now that everything seems to look normal (aside from a little swelling/redness) i think i may wait one more day and see if now that ive removed that if the redness goes away? What do you think? Do you think im ok to wait one more day and keep a close eye on her before deciding to takeher in?
doctor
Answered by Dr. Sumanth Amperayani (7 hours later)
Brief Answer:
Skin slough is skin dermal elements which are cast out

Detailed Answer:
Hi...

1. Skin slough is skin dermal elements which are regularly cashed out while being replaced by new skin dermal elements. You need not worry as this is normal phenomenon. But why should it accumulate so deep - that is what is concerning me

2. You said that the region is red and swollen but you have not posted image. I can understand your concern about not posting the image here. But without seeing I cannot decide whether you can wait or not as this is a skin problem. If it had been other system involvement I would have decided after asking certain questions but now I suggest you make an appointment with her pediatrician and get her examined. I cannot decide based on seeing the image of the slough.

Regards - Dr. Sumanth
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8339 Questions

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Suggest Treatment For Skin Infection Near Urethra

Brief Answer: Could be a fungal infection or skin desquamation remnants Detailed Answer: Hi.....as I was going through your question I thought of asking you to upload a picture, but at the end you had mentioned that you cannot do so. I understand your concern. As you have clearly mentioned that she's not crying while urinating it cannot be a urinary infection. By what you quote I feel that the possibilities are - 1. Fungal infection. 2. Skin desquamation remnants accumulating there. 3. Vaginal synechiae. None of them is an emergency. Do not worry. But do not try to remove or wipe by force. Regards - Dr. Sumanth