Pediatrics/18 month on swollen glands and worsening eczema
QUESTION: My son is 18 months old, he was born with 3 swollen lymph glands on the back of his head. Right after he turned 1 I noticed he had swollen glands all over his body. He also in the last 2 months has developed eczema and it is getting really bad. No lotions or creams are helping. He also still has gland swelling his labs have all been pretty normal nothing anyone has been concerned with. The Doctor says his eczema is affecting his glands but the glands came a year before his skin issue.
I'm at a total loss
ANSWER: Hi, Channa,
It is debatable if infants who are normal are born with nodes that can be felt at birth. It is possible these three where some kind of benign cyst, in the area you describe. Eczema is a chronic inflammatory disease and often will stimulate node enlargement in all parts of the body. If routine labs are normal, if your baby is growing and developing well, then these are probably benign reactive lymph nodes and just need to be followed with the routine exams.
Good luck, Dr. Olson
---------- FOLLOW-UP ----------
Labs have been somewhat normal slightly elevated white counts, RDW high but hematocrit and hemoglobin were low, and he had abnormalities with his red blood cells (shapes and sizes I believe) One doctor was concerned another said that it was normal due to the sensitivity of the equipment we currently use. I struggle most with the "what came first the chicken or the egg" He has only had eczema for the last 8 months, his nodes have been swollen since he was for 16 months. So are the nodes causing the eczema or are these both being caused by something else. His eczema is progressively worsening and is now all over his body when it originally started with a dry patch of skin of the back of his neck that was easily treated. He has circular dry patches all over along with tiny bumps. It is not scaly and it doesn't scrape off it its just a circular raw spot of skin. I know its impossible to DX without seeing him but can you possibly think of any tests I can ask for that would either confirm it is or is not eczema or can actually look at his lymphatic system? His immune system testing came back normal.. Developmentally he is fine however he has been diagnose failure to thrive due to his struggle with weight gain since birth.
The nodes (or whatever they are) will not cause eczema. Eczema is a visual diagnosis and there is no testing that is routinely done to confirm that this is what it is. There are rare cases of conditions like the histiocytosis spectrum of disorders that can mimic eczema. I would suggest a visit to a peds dermatologist to confirm what the skin lesions are. They sure sound like pretty classic eczema.
Good luck, Dr. Olson