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Lighter in pigment in chest after 2nd DEGREE BURN.

Resolved Question:

Hello!
My son is 14 months old and I am worried because, as you see in the photos attached, it seems that his chest area is slightly lighter in pigment than his belly area. I am afraid I am a bit of a hypohondriac, but I wonder if you could be so kind and answer my question. The boy is developmentally OK. He has no seizures, he says 3 or 4 words and has started walking at 13 months of age. He is very curious and smily.

Father and mother are Mediterranean. The mother is quite dark skinned. In addition, the boy had a 2nd degree burn when he was 2 months old. The burn was not serious, and a rather small blister remained for some days on his left shoulder. The burn initially turned red his whole left breast and shoulder, and a part of his neck (left). The burn subsided within two hours, leaving the blister I mentioned. We put Fucidin for three or four days on the blister.

Thank you in advance!


Category: Pediatrician

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Category: ICU/ Critical Care Specialist
Dr. Saptharishi L G is online now

Expert:  Dr. Saptharishi L G replied 4 Days.

Dear Parent,
Thank you for your consult at DoctorSpring.com. I understand your concerns.
Every parent has a few things bothering him/her. Curiosities and queries are part of parenthood. That is only natural.
The phenomenon that you have described is very similar to 'TANNING'. The covered portion of the body tends to be lighter than the sun-exposed parts. This is because exposure to sunlight stimulates MELANIN (pigment responsible for wheatish/dark skin) production in the skin. Therefore, in your son, the upper chest and his arms are lighter than his belly and forearms. This is quite normal.
If you re concerned about the cosmetic outcomes, you could try using a SUNLOTION with SPF of at least 15 to decrease these effects. But, frankly, sun exposure helps in VITAMIN D production and hence, is good for the child's bones and growth. So, it would be best to leave him alone and let him enjoy his growing-up.
Hope this helps, would be glad to answer any queries.
Regards
Dr. Saptharishi L G
Note -
Your consult was upgraded for free to a specialist consult since it needed a reply from Pediatrician for to be more helpful and accurate. Kindly utillze consulting a specialist in future when the consult merits.


Patient replied :

Thank u for your prompt answer. My question is why is the chest lighter? I think that his chest and belly are equally exposed to the sun. In addition, his breasts are partly darker as well. Especially the right one.
Sorry for being too scholastic.
Thank u again.


Expert:  Dr. Saptharishi L G replied 3 Days.

Dear Parent,

The pigmentation level in each area of the body is both genetic and acquired. It is possible that your son has such a benign (harmless) difference in regional pigmentation. There is no need for undue concern as it is likely to become uniform as he grows up.

If you are suspecting something like a hypopigmented patch as part of something bigger like a developmental disorder (Tuberous Sclerosis), please be rest assured that it is nothing of that sort. What your child has is a completely normal and harmless variation in pigmentation of his skin.

Please do not worry.

Regards.


Patient replied :

Thank you very muvh for your prompt reply.
May I ask one more, slightly irrelevant question?
As, I already said, my boy had a 2nd degree burn when he was 2 months old. The burn was not serious, and a rather small blister remained for some days on his left shoulder. The burn initially turned red his whole left breast and shoulder, and a part of his neck (left). The burn subsided within two hours, leaving the blister I mentioned. We put Fucidin for three or four days on the blister.
The blister resulted in a small, red scar, that later started to move down his back. A few months later it was pinkish and had moved 5 or 6 cm down his back. Now it has moved a little more, but not much, and is not very discernible.

My question is: is it normal for scars to change place like that? Does baby skin stretch as he grows, resulting in such an effect?
Thank you very much in advance.


Expert:  Dr. Saptharishi L G replied 2 Days.

Hello.
Second degree burn in a 2-month old baby sounds significant. The description that you have provided subsequently appears to be more a first degree burn (erythema). Movement of the scar actually does not happen. It appears so because of the pattern in which different parts of the body grow in relation to each other.
Burns sometimes lead on to a hypertrophic scar or keloid. These scars are different in fact that they rise above the surface and grow beyond the margins of the wound due to excessive proliferation of fibrous tissue. These scars increase in size over the years old patientand may require intervention to prevent cosmetic disfiguration. I hope that you are not referring to any such observation. Otherwise, there is no need for worry in your case.
Feel free to discuss further,
Regards.


Dr. Saptharishi L G
Category: ICU/ Critical Care Specialist
Experience: 
Senior Residency: DM,  Pediatric Critical Care, PGIMER

Residency: MD, Pediatrics, Postgraduate Medical Education & Research (PGIMER), Chandigarh, 2013

Internship: JIPMER, 2009

Medical School: MBBS, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry, 2008
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