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Dr. Hive-urgent care or wait it out


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My DS (11 months) has always had a rash around his mouth. A month ago, He tested as allergic to 6 out of the 9 top foods but cutting them has not improved the rash. He got a cold last week, went to UC and they prescribed amoxicillin for ear infection but he got a rash from that so doc said to stop and didn't switch to anything. This is his face today, rash has moved up around his eyes and he's puffy. We have appointments in two weeks with regular pediatrician, allergist and derm but I'm wondering if I should bring him in to urgent care for this. His skin is just so sensitive to everything but I don't know that urgent care could do anything we aren't doing. Any ideas if you have a kiddo with skin-affected allergies is welcome!

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Could you get a same-day "sick" appointment with the pediatrician tomorrow? I've got 2 food allergy/eczema kids who are fine now at 12 and 14 but one had 3 skin conditions as a baby and the other one had 4 skin conditions. If I were back at that time and one of them had this rash on their face, I would have wanted them to be seen and to be given a list of things to try until we could get to the dermatologist.

Sweet baby!!!!! I hope it's not bothering him too much.

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37 minutes ago, CTVKath said:

Could you get a same-day "sick" appointment with the pediatrician tomorrow? I've got 2 food allergy/eczema kids who are fine now at 12 and 14 but one had 3 skin conditions as a baby and the other one had 4 skin conditions. If I were back at that time and one of them had this rash on their face, I would have wanted them to be seen and to be given a list of things to try until we could get to the dermatologist.

Sweet baby!!!!! I hope it's not bothering him too much.

I might be able to do a virtual appt tomorrow, they don't do same day in person. 

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Just now, prairiewindmomma said:

Are you already dosing with Benadryl per dr orders?

No I didn't know babies could have benadryl. Interesting....

The urgent care doc last week suggested hydrocortisone but only for 3 days so it doesn't thin the skin too much

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Fwiw, lots of kids rash off of amoxicillin. Test him to see if he is actually allergic when you do more testing because knocking out penicillin based drugs as a class is a big deal. Many skin sensitive kids will rash out just from viral stuff and a viral infection which caused enough inflammation to cause an infection may have triggered the rash rather than amoxicillin.

Honestly, if you are already hooked up with an allergist, I’d call their after hours number for advice. 

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Adding (before I step out for a bit), know the baby’s weight before you call the allergist. We got the ok after baby was 6 months, but you dose by weight.

The fact the rash is spreading rather than retreating would have me calling…or doing urgent care. That rash doesnt look like one I would do hydrocortisone for. That only is for itchiness and I really hate all steroids + baby skin. You want something systemic and dealing with the underlying inflammation, not just the itchiness.

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41 minutes ago, prairiewindmomma said:

Adding (before I step out for a bit), know the baby’s weight before you call the allergist. We got the ok after baby was 6 months, but you dose by weight.

The fact the rash is spreading rather than retreating would have me calling…or doing urgent care. That rash doesnt look like one I would do hydrocortisone for. That only is for itchiness and I really hate all steroids + baby skin. You want something systemic and dealing with the underlying inflammation, not just the itchiness.

Thanks so much!

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Everything prairiewindmomma said.

I would call the pedi, the allergist and the derm — even if you haven’t seen them yet. Maybe try to get in early.

I would want that seen, because it’s not improving.

Take lots of pics and keep good records.

Hugs. Allergies are hard. We have multiple food allergies here, too, plus skin stuff. 

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I can take amoxicillin but react to generic penicillin. My doctor told me to take note of manufacturer the next time I have a drug reaction. My DS19 when he was an infant was prescribed augmentin (liquid form) and that seems to work better than amoxicillin for him. I can’t remember his exact weight but he was between 20 and 24 pounds. 
My local urgent care isn’t as good with allergies. We had more luck going in to his pediatrician clinic and his pediatrician would take a look when he has a patient that didn’t take up the time allocated or the next patient is late. DS19 get hives easily while DS18 has eczema.

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Poor kiddo! I agree with making the call(s). UC is most likely useless, as it’s already been determined mysterious enough to require deeper investigation.

ETA: I say that assuming no breathing issues are or become involved.)

On a positive note, my ds with minor childhood allergies and rashes grew out of it. My nephew with severe allergies is experiencing fewer rashes at age 5. And my youngest son hasn’t had that very similar rash since we banned sugar alternatives in his diet (specifically monk fruit, but we nixed all out of precaution.)

 

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Poor baby! I’d do as others suggested and call all 3 doctors’ offices and try to get in. I also agree about the hydrocortisone—unless it’s just crazy-itchy (I hope it isn’t!), I don’t think that’s the best choice for a baby’s face, especially so close to the eyes. We’ve had good luck with this, although my kid is a teenager now, not a baby. 

I hope he can be seen today and gets some relief!

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I would definitely try to get him in right away with the allergist (tip:  sometimes the receptionist is hard to get past, but if you ask to speak to a nurse, they can override the receptionist and get you in).  Our allergist always preferred Zyrtec to Benadryl.  Internet has dosing info.  The rash plus puffiness would be concerning to me, and I would try to give child something, but maybe talk to allergist nurse/doctor first.

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52 minutes ago, almondbutterandjelly said:

I would definitely try to get him in right away with the allergist (tip:  sometimes the receptionist is hard to get past, but if you ask to speak to a nurse, they can override the receptionist and get you in).  Our allergist always preferred Zyrtec to Benadryl.  Internet has dosing info.  The rash plus puffiness would be concerning to me, and I would try to give child something, but maybe talk to allergist nurse/doctor first.

Zyrtec offers better control but is not approved for children under 2. 

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52 minutes ago, almondbutterandjelly said:

Oh and no hydrocortisone on the face!!  Protopic (if you have some) is acceptable for the face.  Maybe some Cerave cream.

Same with protopic/tacrolimus. I use and love tacrolimus personally, but not approved for children under 2. 

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3 minutes ago, prairiewindmomma said:

Zyrtec offers better control but is not approved for children under 2. 

Yes, I see that some places on the internet say that.  As my own dd was on Zyrtec and Protopic (prescribed by the allergist) from age 1 onward, I will agree to disagree.  Definitely, OP, talk to someone at the allergist's office.

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Just now, almondbutterandjelly said:

Yes, I see that some places on the internet say that.  As my own dd was on Zyrtec and Protopic (prescribed by the allergist) from age 1 onward, I will agree to disagree.  Definitely, OP, talk to someone at the allergist's office.

I will agree to that…see a dr and see what they will write for. We had an older ped allergist who was rather strict.

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Just as a heads up, it’s not uncommon for eczema and secondary impetigo to kind of circle around each other. One of mine deals with that. Eczema is fundamentally a leaky skin barrier and microbreaks in the skin from scratching an itchy place or open wounds from the eczema itself are prone to infection. 
 

 

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18 minutes ago, prairiewindmomma said:

Just as a heads up, it’s not uncommon for eczema and secondary impetigo to kind of circle around each other. One of mine deals with that. Eczema is fundamentally a leaky skin barrier and microbreaks in the skin from scratching an itchy place or open wounds from the eczema itself are prone to infection. 
 

 

I wondered if this would be a common thing. Hopefully we can figure out his allergies and get the eczema under control...

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48 minutes ago, Momof4sweetkids said:

Thanks everyone! We were able to get in with his pediatricians office, different doc, and found out it's impetigo. Got a prescriptionG. lad I brought him in, hopefully derm and allergist will have some better long term solutions.

I'm so glad he was seen and diagnosed.  Hope the Rx helps very soon.  

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11 minutes ago, Momof4sweetkids said:

I wondered if this would be a common thing. Hopefully we can figure out his allergies and get the eczema under control...

For that kid, bleach baths have been helpful (less for the antibacterial/antifungal aspect but because bleach somehow changes ph levels of your skin?) as well as using hibiclens during impetigo outbreaks. That particular kid got a standing zpac rx after his third impetigo round in 6 months because early treatment (first bubbles along his lipline) seems to be crucial. I start him on it as soon as he notices it (he feels tingles). I am really not wild about antibiotic use generally (and this kid does take regular probiotics), but recurrent staph infections are scary. Recurrent staph infections are associated with certain autoimmune issues—lupus, RA, and MS—and there’s some concern that the infections themselves may be triggering genes and thus disease. Given that I have RA, it’s on our radar and it’s concerning. 
 

None of this was well known when we started with baby allergies 20+ years ago…but if you know you have family genetics for autoimmune stuff generally, I wanted to give you a heads up.

Hopefully his body will sort itself out with time. That has happened for a couple of mine!

 

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