Sariya El-Suleiman was a year old when a rocket hit his family’s home outside Damascus. Four years later, a skin disease that he developed after the attack is still perplexing doctors.

GHAZZE, Lebanon — Amal Ismail El-Suleiman dropped a handful of creams and ointments on the floor of her home. They were just a few of the more than 15 she had tried on the skin disease that has covered her son Sariya’s face over the past four years.

The condition also manifests itself on the back of his neck and hands, and looks more like a burn — red and blistery — than a rash. It started four years ago after the family’s home, on the outskirts of Damascus, Syria’s capital, was hit by a rocket late at night.

In the chaos, Ms. Suleiman and her husband ran out of the house with their four older children and forgot Sariya, who was just a year old.

“We went back to get him,” she said. “He was covered in black dust.”

The whole family developed a rash, Ms. Suleiman said, but after a month it disappeared from everyone but Sariya.

A doctor prescribed medication after medication, but nothing worked. “I tried them all,” Ms. Suleiman said, pointing at the pile of creams on the floor. She pulled out envelopes filled with medical results dating back to 2014 — blood tests, urine analyses, even an X-ray of Sariya’s arm and hand to check his bones. The family believes the rash was caused by a chemical in the explosion, but nothing was conclusive.

“The doctor said he didn’t know what it was,” Ms. Suleiman said. In 2015, the doctor asked for a thyroid test, but it cost $400, and Ms. Suleiman said the family could not afford it.

The rash eases up in the winter, Ms. Suleiman said, but even on a bitter cold December day, Sariya’s face was bright red and dry. Sariya, now 5, sat on his mother’s lap in their apartment. He smiled and made eye contact with visitors, but became shy when a stranger asked him a direct question.

Sariya said the rash did not hurt or itch, but his mother said that sometimes he scratched his face and it bled.

The family was living in Bowayda, outside Damascus, in 2012. There was almost no food left as Syria’s civil war raged, and what was at the markets was too expensive. Rice, Ms. Suleiman said, cost up to $15 for about a pound. Sometimes the family would secure small portions of grains, sugar or lentils, and ration that among the seven of them for weeks. By 2013, she said, there was nothing left at the markets.

Sariya during a school exercise. The other children are kind to him for the most part, said Lozan Kurdi, a teacher, but some have stopped going to class because they are scared of his skin condition.

Sariya during a school exercise. The other children are kind to him for the most part, said Lozan Kurdi, a teacher, but some have stopped going to class because they are scared of his skin condition.

“There was no food, no milk and no medicine,” Ms. Suleiman said. “We ate grass and herbs from the ground. This is food you usually give to cows.”

Everyone in the family lost weight.

“We were just bones,” Ms. Suleiman said. She would breast-feed Sariya, but she was not sure if she was producing enough milk.

“I tried,” she said. “If not, he would have died.”

After the rocket hit the house, the family went to stay with Ms. Suleiman’s parents in the same village. Sariya’s rash continued to worsen. They stayed there for four months before armed men came and ordered them to evacuate from the house.

Sariya has a hard time concentrating at school. “He’s very sensitive,” Ms. Kurdi said. “Sometimes when he gets sad, he just shuts down.”

Sariya has a hard time concentrating at school. “He’s very sensitive,” Ms. Kurdi said. “Sometimes when he gets sad, he just shuts down.”

“They told us we had to go only for one night,” Ms. Suleiman recalled. The family took just a few things for the overnight stay and left. But they were never allowed back.

For eight months, they camped out in an abandoned house in a nearby village before fleeing to Lebanon in 2014.

At first, they lived in Beirut, in an automotive garage where Ms. Suleiman’s eldest son found work. But the hot, humid weather aggravated Sariya’s rash and they moved to Ghazze, in the Bekaa Valley, which has cooler weather. Ms. Suleiman’s husband also works, but the money he and the oldest son make is barely enough to cover food for the family and the rent on their three-room apartment.

Despite Sariya’s struggles, his mother, Amal Ismail El-Suleiman, said he was happy at school: “Every day he comes home and tells me what happened in class and sings the songs they learned.”

Despite Sariya’s struggles, his mother, Amal Ismail El-Suleiman, said he was happy at school: “Every day he comes home and tells me what happened in class and sings the songs they learned.”

Credit

Diego Ibarra Sanchez for The New York Times

Sariya saw yet another doctor in the Bekaa Valley. “She gave us more cream and told us to keep him outside of the house more,” Ms. Suleiman said. But there was still no improvement.

Sariya now attends a kindergarten operated by the International Rescue Committee, one of the eight beneficiary organizations of The New York Times Neediest Cases Fund. At least 250,000 Syrian children in Lebanon are not attending school, missing out on important years of education. The committee’s programs support 7,700 Syrian refugee children across Lebanon with math and literacy lessons, in Arabic and English, in addition to helping to build social skills.

In his class, just across the street from his home, Sariya sat around a table with other Syrian children, looking noticeably smaller; even with his heavy sweater, loose jeans and wool hat, his slight frame was obvious.Sariya with his sister Amani. After the rocket hit the family’s home in Syria and they were forced to leave relatives’ home, they camped out in an abandoned house for eight months before fleeing to Lebanon in 2014.

Sariya with his sister Amani. After the rocket hit the family’s home in Syria and they were forced to leave relatives’ home, they camped out in an abandoned house for eight months before fleeing to Lebanon in 2014.

Sariya has trouble focusing. His teacher, Lozan Kurdi, said his behavior was common among Syrian children who had been through the sort of trauma he had experienced, but that Sariya had a particularly hard time in class.

“He’s very sensitive,” Ms. Kurdi said. “Sometimes when he gets sad, he just shuts down.”

For the most part, the other children are kind to him, she said, but some have stopped going to class.

“Some of the kids are scared of the way he looks,” Ms. Kurdi said. “Some parents say they don’t want to bring their children here because of him.”

She is sure, on some level, that that is affecting Sariya.

During recent class assessments, Sariya had trouble concentrating on even simple questions like where he was from. He struggled to select the largest of three circles on a piece of paper. Developmentally, Ms. Kurdi said, he is at the level of a 3-year-old.

Going to school has helped Sariya a lot, Ms. Suleiman said. Before he was allowed to go, he would sit at the door of their home and cry as the other children went off to class, she said.

“He’s so happy at school,” Ms. Suleiman said. “Every day he comes home and tells me what happened in class and sings the songs they learned.”

Ms. Suleiman said that while the school had helped Sariya emotionally, she wanted him to see a specialist for his skin and get the more expensive tests.

“We need money for that,” Ms. Suleiman said.