Question:
son has a rash on his trunk for almost a month now. Took him to
the pediatrician and he said it was eczema. We used Aquaphor and
Eucerin, but no change for the better, actually it looks redder,
brighter and itches him more. He's getting cranky about this now. I
don't know what to do next. See the dermatologist or allergist? Should
we be trying elimination diets by ourselves? He's never been allergic
to anything before. My mom has psoriasis, could this be a precursor to
that type of condition. Neither I or my husband have any skin problems,
except I think I have sebhorrea (sp?) on my face and a little on my
scalp, but haven't been to the dr with it, I just use a little cortisone
on it and it gets better. I haven't changed detergent lately. Why
would rash be only on trunk, front and back, worse on front. If it was
a food allergy, would the trash be on the arms and legs? We thought he
had poison ivy at first because he did have itchy rash on face, but that
subsided quickly. He's had rashy reactions to carrying corn stalks and
pumpkins (but I don't think it was hives) in the last three weeks. Ped
said that was part of eczema. Also, in case it could be relevant, he
had acetabular osteomyelitis (bone infection in the pelvis) this
summer. He was on intravenous antibiotics for three and a half weeks,
then orally for additional three weeks. This rash didn't start until
two or more weeks off of the antibiotic.
Answer:
I think your son suffers on a allergy.maybe incause of osteomyelitis his
physical reactoin changed. I think you should go to the allergist. The biggest pointer to the possible
cause of his troubles is the very long course of antibiotics he was given. I
know the rash appeared a couple of weeks afterwards but I would still put a
very large question mark over this. Antibiotics are wonderful life-saving
drugs, but they do cause all manner of skin problems. Talk to his doctor again. Ask for his thoughts about putting your son on a
short and diminishing course of oral steroids to crack the problem. Steroids
have a very bad (and totally undeserved) reputation but used properly in
this manner they are harmless and can be miraculously effective in bringing
the most fearsome of allergic reactions under control. If it was indeed a
reaction to the antibiotics the steroids should put paid to the problem. If
not, the downside is minimal. While getting to the root of his skin problem the important thing is not to
challenge his skin. Avoid strongly perfumed, enzyme-based laundry products.
Don't use fabric conditioners.He should dress as coolly and loosely as is
practical. Bedding should be cool. His baths should be tepid and brief
(followed by a light dabbing with an old, user-friendly towel (no vigorous
rubbing sessions!) Just because his doctor has prescribed various emollient creams, don't
imagine that they can't be worsening his problem - preservatives and other
ingredients may be causing trouble. Ask to try other emollient creams (it's
important that you do find one that suits his skin - thorough and continuous
moisturising will greatly reduce its itchiness)
If your son is scratching his trunk, keep his finger nails as low as you
can, and if necessary put cotton gloves on his hands at night to prevent
scratching during his sleep. All that said, I feel confident that your son's condition IS temporary and
will go away quite soon, and I certainly wouldn't start worrying about the
possible role of food intolerance at this stage. One of the big problems with long courses of
antibiotic treatment is that they can cause candiasis - antibiotics wipe out
harmless bacteria in the gut and allow overgrowth of a yeast-like organism
called candica albicans. One of the symptoms of canidiasis is urticaria.
Talk to your son's doctor about this possibility if he has any of the
following (in addition to his skin problems):
1. Oral thrush
2. Anal itching
3. Bowel problems including diarrhoea, flatulence, bloating and pain
4. Indigestion
5. Complaining about pains in his muscles or joints
6. Unusual tiredness, depression, irritability or inability to concentrate.
Of these, the biggest pointers to candidiasis are the first three.
Candidiasis responds well to anti-fungal medications. I did ask the pediatrician if it could be
related to the antibiotic and he didn't think it could be, but I don't
consider any doctor to be perfect. He could be wrong. Would the
antifungal be an oral or topical medication? Yes, but I always have. What puzzles me a bit is why is the rash only
on the trunk, not on the legs and arms? I'm covering the mattress in
the allergy cover and have washed all bedding in hot water. I noticed
he doesn't sleep in a shirt, just pants. Thats why I'm investigating
the mite angle.
