Dr. Hive - Rash Identification?

[ktgrok]

DD3 started with a rash just over a week ago. it was on her upper thigh/edge of rear end, where the elastic of her bathing suit leg opening/edge of pull up/etc is. Very itchy. I thought maybe something had been in her wetsuit she wears over her bathing suit in the pool, or even just some bacteria from it sitting outside to air dry or something. But she has a history of bacterial diaper rashes when she was younger, and the next day there were what looked like pustules or blisters, and DS with PANDAS was flaring so we got a telemedicine visit and him on augmentin for possible strep exposure and her some mupirocin ointment. That always cleared her up immediately. 

But, this has actually spread now, despite using the ointment prescribed, then trying yeast cream, etc. Still itchy, fewer blister/pustule things, more flat like hives. Looks like prickly heat when I try to search google, but there is no reason she'd have that - we have air conditioning, she hasn't been out playing in the heat, etc. When we go out she swims or plays in the hose/sprinkler, etc so not all hot and sweaty. And that wouldn't explain why it isn't going away and is spreading. Pollen is bad - could this be a weird pollen/allergy thing? I gave benedryl today and it maybe helped a bit temporarily? 

Telemedicine doctor thought it looked viral like hand/foot/mouth, but she's been isolated at home, only adults leaving the house, masked, showering afterward, etc. All packages disinfected. And no blisters/bumps on hands or feet or mouth. So, that seems unlikely. And i woudln't think spreading now a week later? 

Gets redder after a warm bath (normal I think). I did an oatmeal bath this afternoon. Any thoughts, other than continue benedryl? I tried cortisone once in the beginning and it seemed to make it worse, so I'm hesitant to do it again, but might need to try it again. 

First picture is from a week ago, the one with the tube of ointment next to it. Others are from this morning. It is now covering a much larger area on the original thigh, plus on the other thigh, plus going down her leg. 

[Paige]

Molluscum? Looks like it to me but rashes are hard to pin down. If it's molluscum, it can spread with scratching. 

[ktgrok]

10 minutes ago, Paige said:

Molluscum? Looks like it to me but rashes are hard to pin down. If it's molluscum, it can spread with scratching. 

No, I've had a kid with molluscum before, this isn't that. This is more rash like, not individual bump/blisters. At least, I don't think molluscum comes like this - some areas are flat more like hives. 

 

[Martha in GA]

poison ivy?

[cintinative]

Hmm, it looks like the way my kids' molluscum looked. Is poison ivy a possibility though? Or poison oak/sumac?

This soak works for poison ivy and it also worked well for chigger bites last year. https://www.amazon.com/Domeboro-Medicated-Relief-Powder-Packets/

Edited April 26, 2020 by cintinative

[prairiegal]

I'm usually a lurker, but I had to come out on this one.  MY eight year old daughter has a rash that looks identical to that going on right now.  We have been unable to identify it.  Where we live there is no way it is heat related.  My older daughter is a nurse, and she wasn't sure what it is either.  She has been playing in the barn quite a bit lately.  My gut tells me it isn't allergy.  She hasn't been anywhere to contract anything either.  Interesting.  I am anxious to hear what others think.

[almondbutterandjelly]

Contact dermatitis?  Have you tried the benadryl cream?  Not just the oral stuff but the cream that you rub in on the spot?

https://www.walmart.com/ip/Benadryl-Original-Strength-Itch-Relief-Cream-Topical-Analgesic-1-oz/10294032

If that doesn't work, Dessitin might kick it.  (We've had lots of rashes in our household.)

 

Edited April 26, 2020 by perkybunch

[ktgrok]

4 minutes ago, cintinative said:

Hmm, it looks like the way my kids' molluscum looked. Is poison ivy a possibility though? Or poison oak/sumac?

Man I hope not! It is a lot, and those take forever to go away. Also not sure how she would have been exposed when home all the time?

This is another picture, I'll delete it later. 

[ktgrok]

10 minutes ago, perkybunch said:

Contact dermatitis?  Have you tried the benadryl cream?  Not just the oral stuff but the cream that you rub in on the spot?

https://www.walmart.com/ip/Benadryl-Original-Strength-Itch-Relief-Cream-Topical-Analgesic-1-oz/10294032

 

 

I'm starting to wonder if that is it. I haven't, but will see about getting some, or trying the cortisone again in a small area. She hasn't worn the wetsuit since that first time I don't think, but maybe? I guess neoprene can cause dermatitis in some people. 

[cintinative]

The trouble is if it is molluscum then putting a steroid on it will make it worse. My husband has molluscum and eczema in the same area and the treatment for the eczema is steroid but now that has aggravated his molluscum.

I would probably try the benadryl cream first.  

Do you have a pediatric dermatologist? 

[Paige]

 

7 minutes ago, cintinative said:

The trouble is if it is molluscum then putting a steroid on it will make it worse. My husband has molluscum and eczema in the same area and the treatment for the eczema is steroid but now that has aggravated his molluscum.

I would probably try the benadryl cream first.  

Do you have a pediatric dermatologist? 

My DD had molluscum and eczema and it was pretty bad. I'll see if I can find a picture for OP because it looks a lot like it did for DD before it exploded, but the dermatologist said to take turns with the steroid/and whatever it was they gave for the molluscum. You treat the molluscum first as far as possible, if eczema starts to crack, use the steroid until it heals, then go back to the molluscum. 

 

[ktgrok]

23 minutes ago, cintinative said:

The trouble is if it is molluscum then putting a steroid on it will make it worse. My husband has molluscum and eczema in the same area and the treatment for the eczema is steroid but now that has aggravated his molluscum.

I would probably try the benadryl cream first.  

Do you have a pediatric dermatologist? 

Oh, good point! 

I'll get some benedryl cream asap, if I don't have any. I don't think I do, but i will check. 

I don't have a pediatric derm, haven't needed on, but will check if my normal derm does kids. If I have to go into a medical office I'd rather it be a place that doesn't treat lots of respiratory infections like the normal pediatrician's office. So derm is a good call. 

Edited April 26, 2020 by Ktgrok

[Katy]

DH developed a rash like that on his leg when he developed an allergy to Tide. We had to switch to All Free & Clear.

Of course that doesn't explain the PANDAS flare.

[ktgrok]

1 hour ago, Katy said:

DH developed a rash like that on his leg when he developed an allergy to Tide. We had to switch to All Free & Clear.

Of course that doesn't explain the PANDAS flare.

Honestly, the PANDAS could be from anything....he has been licking his skin aroun dhis lips so could have gotten that infected, or been exposed to something before all this started. Looking back, there was a gradual ramping up of symptoms for a while now. 

[ktgrok]

So, she's had another dose of benedryl, and definitely took the redness and severity down. I gave her the oatmeal bath, then washed with chlorhexidine surgical scrub, rinsed, then dabbed on more of the oatmeal "juice" before slathering in A&D ointment which seems to help as much as anything. Definitely looked better before bed - less raised. 

Now did the benedryl help, or the oatmeal, or the chlorhexidine or the ointment functioning as a barrier or??? No clue, lol. 

Maybe her pull ups changed formulation? 

She was 100 percent potty trained for pee before all this quarantine stuff threw our schedules off, so she's back in pull ups, and wetting in them several times a day. So that is a factor too. 

[prairiewindmomma]

It looks like an irritation type rash—either allergy or contact dermatitis. Dd developed the same type of thing today. 
 

Is she getting a chance to shower well after being in the pool? Is the pool balanced well? 
 

My other thoughts are tied to the pull-ups...if this continues I would try to get her back into undies only ASAP.

[Tap]

Looks a lot like folliculitis to me. I would keep using the chlorhexadine 1 to 2 times daily. Then mix 1 part mupirocin, 1 part antifungal (preferably lamisil/terbinafine) and 2 parts diaper cream. I would put a pair of light weight pants on her to reduce rubbing/chaffing on surfaces. Keep giving her the oral benadryl to keep the itching under control. Make sure she is changed immediately after peeing or get rid of the pull ups all together. Bath in the morning if she is primarily using them at night. If she will let you use a hair dryer to completely dry the area, try that too. I  don't know if it is humid there yet, but it can be hard to treat fungal infections on moist/warm skin. 

If the area is on the parts of her skin that touch her carseat, booster-seat, kid chair or highchair, I would wash the seat with a disinfectant. If she has a pool, I would test the water or dump and let sit in the sun for a few days. Wash the wet suit in a disinfectant.  Think about any  source of contaminated water she could  be playing in (puddle that  forms in the grass etc). If it is bacterial, it may not be going away because she is reinfecting it. 

For the idea of heat rash.....kids can get heat rash from car seats or just sleeping hot under a blanket. Restarting pull ups at night, if the weather is getting warm there, could be the culprit.

 

One other thought is to make sure it isn't a mite or sand flea bite if you have a sand pile in the yard. 

DD21, reacted to her own pee as a baby. I had to use aloe vera on her skin instead of diaper cream. When it was really bad, I had to use SSD cream (the cream used for burns). Her rash was red hot and spread out (not like your daughters). It is pretty amazing what aloe does for rashes. It may be worth a try. 

Edited April 26, 2020 by Tap

[J-rap]

I don't think it's poison oak or poison ivy, but I used to get one of the two from time to time as a kid (can't remember which now -- whichever one was most common on the west coast!), and the one thing that would speed up the recovery was salt baths or swimming in the ocean..  So, unless you think it could make something worse, you could always give that a try?  I remember swimming in the ocean (which I did a lot growing up) used to seem to heal lots of little skin things I had, not just poison oak/ivy.

.

[ktgrok]

4 hours ago, Tap said:

Looks a lot like folliculitis to me. I would keep using the chlorhexadine 1 to 2 times daily. Then mix 1 part mupirocin, 1 part antifungal (preferably lamisil/terbinafine) and 2 parts diaper cream. I would put a pair of light weight pants on her to reduce rubbing/chaffing on surfaces. Keep giving her the oral benadryl to keep the itching under control. Make sure she is changed immediately after peeing or get rid of the pull ups all together. Bath in the morning if she is primarily using them at night. If she will let you use a hair dryer to completely dry the area, try that too. I  don't know if it is humid there yet, but it can be hard to treat fungal infections on moist/warm skin. 

If the area is on the parts of her skin that touch her carseat, booster-seat, kid chair or highchair, I would wash the seat with a disinfectant. If she has a pool, I would test the water or dump and let sit in the sun for a few days. Wash the wet suit in a disinfectant.  Think about any  source of contaminated water she could  be playing in (puddle that  forms in the grass etc). If it is bacterial, it may not be going away because she is reinfecting it. 

For the idea of heat rash.....kids can get heat rash from car seats or just sleeping hot under a blanket. Restarting pull ups at night, if the weather is getting warm there, could be the culprit.

 

One other thought is to make sure it isn't a mite or sand flea bite if you have a sand pile in the yard. 

DD21, reacted to her own pee as a baby. I had to use aloe vera on her skin instead of diaper cream. When it was really bad, I had to use SSD cream (the cream used for burns). Her rash was red hot and spread out (not like your daughters). It is pretty amazing what aloe does for rashes. It may be worth a try. 

Funny you mention that, I actually considered the SSD cream when it was looking bad. It isn't quite that angry now though. This kid has way more sensitive skin, I sometimes forget that. The others don't (I do), but this is the only one to ever have a bleeding diaper rash, etc. 

I DID realize that DD10 has made lemonade a few times recently - in the past lemonade caused DD3 to get diarrhea and diaper rash. I thought the rash was from the contact with the diarrhea, but maybe even without diarrhea she gets a rash from it?

I do have aloe growing in the yard and can try that. 

4 hours ago, J-rap said:

I don't think it's poison oak or poison ivy, but I used to get one of the two from time to time as a kid (can't remember which now -- whichever one was most common on the west coast!), and the one thing that would speed up the recovery was salt baths or swimming in the ocean..  So, unless you think it could make something worse, you could always give that a try?  I remember swimming in the ocean (which I did a lot growing up) used to seem to heal lots of little skin things I had, not just poison oak/ivy.

.

Wish I still lived on the coast! Sunlight helps most skin stuff too. But now we are in the darned middle of the state with no beach. (I greatly dislike this part of the state)

[ktgrok]

So less bumping more flat today in the original area, but more bump showing up going down both legs!

I did remember, I bought a little bit ago different dryer sheets - I ran out of the Mrs. Meyers lavender ones and got Downy or Bounce Free and Clear ones, I forget which. And when I look at the rash, it is NOT on the buttocks, where the diaper covers, but starts at the edge of the diaper - that is where it is worst, and then continues down the legs from there. Oddly, no bumps on the rest of her body that I can find. So maybe the dryer sheets? Doesn't explain why her legs and not her trunk, but that it is not on the area covered by the diaper is a clue?

I feel confident with most medical things. But not rashes. I hate rashes, lol. 

Slathered it with a mix of antifungal, antibiotic, cortisone, and diaper ointment. About to give benedryl. 

Edited April 26, 2020 by Ktgrok

[mmasc]

Is the itching intense? Maybe scabies? 

[almondbutterandjelly]

Oh, just for some anecdotes, my dd once got a rash that, in hindsight, was caused by trying on yoga pants at the ballet store.  Something in the fabric.  It set off a chain of rashes.  Zyrtec and special diaper cream were what kicked that eventually.

Also, for my dd with sensitive skin, any elastic and any non-cotton fabric could cause rashes.  So I would highly recommend underwear and clothing with encased elastic and only 100% cotton clothes for a good long while. 

Edited April 26, 2020 by perkybunch

[stephanier.1765]

This is not to freak you out. My granddaughter had a weird rash for several days too. I was just reading today how they've identified a rash as being one of the symptoms of Covid 19. Sometimes it's the only symptom. Weird. My granddaughter's just disappeared one day. It really was strange.

[Paige]

15 minutes ago, stephanier.1765 said:

This is not to freak you out. My granddaughter had a weird rash for several days too. I was just reading today how they've identified a rash as being one of the symptoms of Covid 19. Sometimes it's the only symptom. Weird. My granddaughter's just disappeared one day. It really was strange.

I had a very weird rash come from nowhere and disappear about 4-5 days later too. A few days after that I had pain with inhalation for 3-4 days but nothing else. I have a chronic cough, so it was there, but not more than normal. It didn't look like the one above, however. It was more like hives and chicken pox. 

I found DD's molluscum pictures and it doesn't look as similar as I thought at first. It could be because I took the picture after it was starting to get bad, and because it was exacerbated by eczema, but the bumps were redder and bigger with a more defined head. Does it itch a lot? If itchy, I'd try steroids (cortisone), if not, I'd ignore it unless it lasted for a week or more or there were other symptoms. 

Edited April 26, 2020 by Paige

[matrips]

Are the pants she wearing from the new laundry sheets?  Or the towel she sat on?  Maybe her T-shirt’s are from previous washings?  

[ktgrok]

2 hours ago, matrips said:

Are the pants she wearing from the new laundry sheets?  Or the towel she sat on?  Maybe her T-shirt’s are from previous washings?  

I think this is VERY possible. 

I rewashed everything tonight, so we shall see. 

also, what helps the most it seems are the oatmeal baths, and just slathering it with A&D ointment, and oral benedryl. Which makes sense if it is contact dermatitis - oatmeal soothes, the ointment has nothing irritating in it and it acts as a barrier between the skin and her clothes, and then of course the benedryl. Cortisone doesn't seem to help BUT I have had that happen myself as well - when my skin is really inflamed the additives in over the counter ointments make it worse - even cortisone cream burns. 

So she'll have all freshly washed stuff tomorrow, and we'll keep doing the rest. It does seem to be helping - less red, less angry.