Any ideas what this rash might be???

[thebluefoxategreensocks]

Just wondering whether anyone has come across a rash like this before? My 2yo son has had it covering his back for over 2 weeks now. It started out fairly high on the back but soon spread to cover most of the back (areas he couldn't even reach to scratch). It's evidently quite itchy though! He has rather severe eczema (all over his body, nearly!), but this rash seems rather different. Mainly in that it won't respond at all to any emollients! The eczema varies in its intensity and when he gets covered in Epaderm at night, provided he doesn't scratch too much in the night, the eczema is fairly calm by morning. But nothing seems to have any impact on his back - and it looks different too! The closest I've come to dealing with it was using Calamine lotion - I nearly thought it was clearing up, but that didn't last and it's gotten worse the past few days.

Anyway, I know doctors have to diagnose things! But I'm getting various opinions without any firm ideas or solutions! One of my midwives (who's own son has eczema) was sure it was a form of eczema; I took him to a GP later that day (about 1.5 weeks ago) and she thought it looked viral rather than eczema (the rash did have occasional spots with heads mixed in around the neck area at that stage); and then I took him to a different GP on Monday and he said it wasn't viral, but perhaps something eczema like though maybe infected? So he prescribed Fucidic acid cream - and is going to write off to get us a referral to a dermatologist (for eczema in general really) but that could take ages! Soooo, just wondered if anyone has any ideas what it might be - it's not nice!

Here is what it looked like on Monday:

i278.photobucket.com/albums/kk108/rachins_photos/misc/rash.jpg

i278.photobucket.com/albums/kk108/rachins_photos/misc/rash2.jpg

and this is what it's like tonight, having gotten rather worse last night/today.

i278.photobucket.com/albums/kk108/rachins_photos/misc/updatedrash.jpg

I don't think the fucidic acid cream is working - but then again, I didn't really feel the rash was infected anyway! So don't really know where to go from here.

This is what the eczema on his feet looks like, which is quite different in many ways to the odd rash on his back:

i278.photobucket.com/albums/kk108/rachins_photos/misc/rash3.jpg

Any ideas?? It's quite stressful trying to deal with this at the moment, as I'm 40w 1d pregnant right now! And he's already waking in the nights with the eczema...so the rash on his back only adds to the problems! But so far visits to the GPs have proved fairly pointless, as they don't seem to really know what it is!

ds1 had eczema for the first four years of his life. treated with steroid cream, emollients bath oil etc, nothing improved it. i switched him from cows milk to goats and it went in 2 days, might be worth a try. always better to stop the cause rather than treat the effect. good luck hope this helps

Rachel - silk base layers? As in vests and long john type thing. Might be worth washing them in calomine tea too. And him as well - buy it loose in health type shops. Worth a try?

you mean like wrapping him in layers of silk? I've tried a bit of wet (and dry) wrapping with crepe bandages, but he got quite annoyed with them when he woke up in the night. At the moment his feet aren't toooo bad (until he manages to scratch or rub them again! ) I've just been putting lots of Epaderm on him at night and a pair of socks. Must see if I can at least find some 100% cotton socks (if such a thing exists) as I'm not sure how breathable his socks are, though they're quite cotton-rich.

Sorry to ask but has he had all his jabs?

Any fever/sore throat?

silk here

and here

This only deals with symptoms though - not cause. Though thats a biggie isn't it. I used to sob when dd1 scratched at her knees, it's so distressing for all.

No, he's not had any jabs actually! And no, no sign of fever or sore throat.

Looks like measles to be honest. I may be wrong though

Maybe you could take him straight to the hospital to rule out any serious skin problems or allergies.
It could be an allergy to washing powder, or he might have developed an allergy towards that particular lotion.
I've just seen the photo, you can cool that rash with a drop of peppermint oil per 1 tablespoon of E45 CREAM not lotion.
Alternative to relieve the itchiness add a local anaesthetic like germolene (amount to size of your thumbnail), 2 very clean tablespoons of E45 cream (Emoilent), 1 or 2 drops of peppermint oil (cooling agent)and 1 drop of pure tea tree oil (antiseptic, antifungal and antiviral properties). Mix it together and apply it once at night and then again in the morning. This will cool the skin and give temporary comfort from itchness. Make sure he wears only cotton over the affected are because nylon or suchlike irritates as you probably already know.

Oh yes, the dermasilk pyjamas and socks/gloves look quite good but are very expensive! I think you can get them on prescription...perhaps if you try hard enough/long enough!

If you get a minute, please browse the links so that you have got as much advice at han as possible.

pediatrics.about.com/od/ezema/Eczema_Treatments_and_Prevention

and

pediatrics.about.com/od/rashes/ig/Skin-Rashes/index.01.htm

FluffyBunnyGoneBad: Don't think it could possibly be measles, as he's had it for about 3 weeks now...without going further than his back!

dweller: Assuming it's nothing life-threatening, as he's had it for a while without seeming otherwise ill. Though when it flares up/looks worse, I do worry about it. And yes, he only wears cotton clothes. Well, socks aren't totally cotton, but as good as I can find.

Yes. I think you would have to make and maintain very stern eyecontact with gp. But s/he aint paying for them themselves and why shouldn't your boy get what he needs. Lung translplants cost a bit but they have to be done. Silk pj's cost a bit but if they are needed then thats what the nhs is there for

Militant rant on behalf of children suffering from crap, non glamorous, low tech illnesses that medicine isn't interested in over. For now.

Suggest saying you got borrowed the socks from a friend and they were a miracle and therefore you think this is way to go.

dweller: I'm quite inclined to think it's Pityriasis Rosea really - he's had several larger "patches" (especially early on) which look very much like the "herald patch" spoken of here pediatrics.about.com/od/rashes/ig/Skin-Rashes/Pityriasis-Rosea.htm and I've read that the rash can look different on different people too, making it hard to diagnose.

That's good (IYKWIM)

tree: certainly the GPs seem to vary in what they think children ought to have. One GP told us allergy testing was 100% useless and if we went private for it we'd just be throwing away lots of money! Another one seemed to think stuff like Diprobase was good....almost only because it's so cheap compared to things we might by ourselve! But a lady GP we saw recently seemed very kind and I almost think she'd have been ready to prescribe what we wanted! She gave us prescriptoin for Aveeno lotion to try (which some GPs think is too expensive, I hear) tho unfortunately I think the lotion makes him feel worse...perhaps Aveeno cream had been better. Just seems there are sooooooooo many things to try...one gets tired!

I know. I know just how you feel. It's knackering. I think a consultant review would bring clarity to all this - it did with our dd and her constipation. Off topic, but still the same feeling.

The quest for a lotion is mega - doublebase made dd1 howl, diprobase great for 2 years but now it makes her itch , so back on the hunt. Joy.

We were just about to pay for a private appt with a pead dermatologist when it all calmed down, so I know how yo feel.

Yes, I saw the patches and I've just read up and cross referenced the link and that does look like a progressive form. If Calamine is working, that's good. Get a dermotologist diagnose for little one anyways, just to be accurate. Wishing you and yours the best of health.

I had Pityriasis Rosea years ago (it appeared just before weekend away with lovely new BF. Terrible timing )
It does look like it could be what I had, definitely worth asking the Dr.

Well, hopefully we'll get to see a dermatologist eventually! The GP we saw on Monday was writing to get us a referral...just a matter of how long it will take for the appoitment to come. I know when I had to see a physiotherapist for my knee once....it took months before they got to me!

Not read to whole of this thread closely, but although not a nurse I have worked closely in the children's dermatology clinics at my local hospital. The rash on his back could well be pityriasis of some sort. I have had this myself - caused by a virus. It will eventually go and you just need to treat any sympotoms (i.e itching or discomfort) with emollients or something like piriton.

The flexures in his feet do look sore and have become quite thickened because of repeated damage by inflammation and scratching. Our dermatologists often prescribe special cream covered bandages for areas like this which give an intensive boost of emollient to such dry and sore areas. These are called VISCOPASTE bandages and work brilliantly. You put them on at night (although they can be worn for 24 hours a day if needed) and secure them with tubifast. SOunds dramatic, but they really do work!

I would thoroughly recommend them and urge you to talk to your GP about trying them(if s/he is any good) or ask for a referral to your nearest paediatric specialist dermatology clinic. If you do get them prescribed and get home thinking 'oh help!' - post again for support!

Good luck!

misspollysdolly: Thank you very much for a really helpful post! Will look into these bandages, they sound ideal! Thanks again! xx

JUst want to respond to the comment that bathing is not good for eczema: Actually bathing is exceptionally good for eczema but only if it is approached somewhat therapeutically - by that I mean the following things:

Keep the water temperature warm-cool

Keep the bath fairly short 10- 15 minutes max.

Use a prescribed bath treatment only (Oilatum Junior, Dermal bath or Double base bath are all very good, although the best would be a big spoonful of Epaderm dissolved in a glass of boiling water first and chucked in as the bath is running) and a soap substitute where needed (Epaderm, dermal).

You must not use ANY product that has soap in at all. Not even shampoo - use a prescribed alternative or not at all, otherwise this will strip away any emollient bath treatments you have been using in the bath. (Imagine your dirty pots and pans being squirted with fairy liquid...this is what soap based products do to already dry skin - Youch!)

When the child gets out of the bath, pat their skin dry - don't rub it as this will irritate it. Then the lovely damp moisturised skin will be ready for some yummy emollient creams or lotions (put loads and loads on!!) (prescribed - NOT perfumed) and steroid creams where needed.

There are so many urban myths about bathing being bad for eczema - bathing is excellent for children with eczema but must be approached differently to your non-eczema-affected child. It is especially useful as children with eczema tend to colonise more bugs on their skin, which can make it more likely fo their eczema to get infected. Bathing helps to keep these bugs to a minimum. Hope this helps!

So far I've had best results using porridge oats tied in a sock (and squeezing out the "juice" into the bath), so it's all nice & milky white! I gave him a bath again tonight (extra one from the usual 2 a week) since it seemed so soothing before. So perhaps he'll have more frequent ones if the oat bath actually helps his skin. Certainly having a bath in Oilatum bath oil made his skin very red and sad looking - and not sure the Aveeno bath oil was that good (tho far better than Oilatum). So the oats are by far the best we've had - the eczema isn't all red when he gets out, like it was with prescribed bath oils/emollients!

I had exactly same response as you Rachel.

misspollydolly - loads of questions for you on bathing! . On the prescribed emmolient front, I am a bit suspicious of them as the list of ingredients is scary, and I hear the 'para - anything' is bad for the skin and various other chemicals. In your experience, are these lotions and potions better that a more natural approach of oats, oils and pure plant derived products?

It's a mind/mine field!