Teddy is a six-month-old boy brought in by his parents with a week of progressive perianal redness.

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<p>Teddy is a six-month-old boy brought in by his parents with a week of progressive perianal redness.</p><p>Teddy’s parents have been applying topical clotrimazole, but the rash has progressed. </p><p>n the past few days, Teddy has developed bright red, sharply demarcated ‘angry-looking’ erythema around the anus.</p><p>They have also noticed bright flecks of blood on his nappy and on wiping.</p><p>Teddy is much more unsettled than usual with nappy changes, although he does seem to soothe quickly after changes and application of a zinc-based barrier cream.</p><p>Teddy is otherwise thriving, and has no past history of note.</p><p>There are no pets at home and his parents are both well.</p><p>On examination, the only abnormal finding is the rash (pictured).</p>

Dr Kate Kelso is a GP and medical editor at Australian Doctor.