Any ideas on skin condition please (picture)

[Claw001]

In early December my son had a tiny patch of dry skin on his face. Late December i made a GP appointment. Before appointment my sons face flared up really severely. Swollen, hives etc.

Managed to get same day appointment. GP didn’t know what it was, said definitely not Dermatitis. Called in a 2nd GP for opinion, didn’t know either. Gave my son anti allergy meds and made appointment to see GP, who specialises in skin.

Anti allergy meds, didn’t help. GP who specialises then gave antibiotics, steroid tablets, steroid cream and more anti allergy meds. It cleared up within 3 days.

The minute he stopped taking meds, it flared up again. Back to GP, who just gave a moisturer on Thursday.

Today, it is getting worse. The whole of my sons face is like this.

Any ideas please?

• [Message from MNHQ: the pic has now been removed at OP's request as she's concerned for her DS's privacy]

Ask for an immediate referral to dermatology?

Psoriasis?

It seems odd the “specialist GP” gave so much as once that you (and he) have no idea what actually was effective!

First 2 GP’s said definitely not dermatitis or psoriasis. Implying allergy. Although nothing has changed.

3rd GP didn’t know, so covered everything and by this time, it had started to look infected.

4th (locum) GP said likely dermatitis and gave moisturer, which seems to be making it worse!

I will ask for a referral on Monday.

How old is he OP?

That's a hell of a lot of meds given by the GP for what was a tiny patch of dry skin. Not good.

It looks very sore...assume it's itchy? It looks like either eczema or uritcaria to me. Suggest some coconut or jojoba oil to soothe it. Bit of piriton liquid if itchy and disrupting sleep. Lots of water, reduced dairy if he has it normally. Keep it simple and see how it goes.

He is 14. Oh no GP didn’t give all those meds for a tiny patch! Meds were after his face had hives and looked similar to now.

It is very itchy, keeping him awake. We have moisturer provided by GP. Seems to be making it much worse. I’m scared to put anything else on it.

The steroids seemed to have worked, however GP said he cannot use for longer than 7 days.

I suffer from allergies and skin issues, so understand how frustrating it must be for you OP...and upsetting as it's on the face, poor thing

I think some creams do make it worse as they create another layer and more heat generates underneath its aim. That's why I tend to use a cold flannel and then dab on a light bit of jojoba or something for a flare up...

You can't use steroids long on the face as they thin the skin.

Is there anything that he's just started using on his face? Any new hair stuff or anything that could transfer to his pillow etc?

underneath iyswim*

No, he has Autism. So literally nothing changes! His diet etc! He doesn’t use hair products or soap or any products on his face, just water. He eats the same thing, day in, day out etc.

I haven’t changed washing powder or anything.

He had allergy testing a while back, unrelated to this or skin. Part of a teacher in school thinking he didn’t have Autism (don’t ask!) He was allergic to tree, grass and shellfish! Although he has never eaten shellfish!

Poor kid...If there really is nothing new then perhaps it's stress related. Some folk break out with these things when anxious etc. Ultimately you need to get him to sleep...so piriton or similar. Tell him not to scratch or put him in gloves! All my advice above stands 're water and dairy. You need to reduce the inflammation in his body. Lots of fruit and veg of course. No hot baths, stick to cooler and quicker showers. It will take a few weeks and in the meantime organise a dermatologist appointment. You can always cancel if it goes while you're waiting for the appt.

Sometimes it's impossible not to scratch. I hate when people tell me not to scratch - usually those who have no idea what it's actually like to have a hot, dry skin condition. If it's a hot skin condition I'd avoid water based creams as they can be very painful. Any oil is very soothing (olive or vegetable oil). I did get a lot of relief from peppermint lotions as they have a cooling effect. Is the rash hotter than the unblemished skin?

I'd also second the advice to request a dermatology appointment as a matter of urgency. He needs to be seen by a specialist, and the sooner the better. I hope it improves quickly for him, it looks very sore.

Yes it is often impossible not to scratch....but worth him making a conscious effort not to. I know all about these conditions as Ive had many of them for 30+ years. My post clearly upset you @Spartasprout. Not sure why I elicited such a patronising response!

Anyway, hope your ds skin improves OP. I feel for him, rotten thing to have.

He has been taking anti allergy meds, every day for a few weeks. Not helping, he is still waking up during the night due to itching. No way would I get gloves on him! 😁 he isn’t scratching, more the itchiness is waking

He doesn’t eat diary (restrictive diet due to Autism) he doesn’t eat veg, just salad and some fruit. (He has been under a dietitian too, has supplements, regular blood tests etc) he isn’t lacking anything.

He wouldn’t go to school initially, which is why GP went all out on steroids. Children are telling him he looks ‘disgusting’ and usual child comments, not wanting to sit with him, in case they catch it etc.

Back to GP on Monday! Thank you for all your suggestions, much appreciated. I don’t know how to help,

I suffer from "normal" eczema and it doesn't look like that.

The only thing it reminds me of is when I had a bout of Seborrhoeic dermatitis (which is an acute from of eczema - hence the "normal" above).

The thing is the steroids initially alleviate the symptoms when you stop using them it gets worse - often much worse.

The redness and scaling are similar to what I experienced.

I'm not a HCP and diagnosing by internet is bad practice regardless, but you might want to ask your GP is this is a possibility.

www.bupa.co.uk/health-information/healthy-skin/seborrhoeic-dermatitis

I just asked him, does it feel hotter (yes still awake!) he said no, just really tight.

It looks like burns on his skin. when I checked it’s spreading, to his neck.

I wasn't being patronising @Claw001, but it's truly horrible having people comment about scratching when you really can't do anything about it.

My DH was the same, until he got a hives type rash and rove his skin apart. He stopped saying it then. I've had 45 years of people telling me not to scratch, but it's involuntary a lot of the time, and sometimes made me feel as though people thought it was my fault and I was making it worse. If you have gloves on you sometimes you scratch more because it's an urge you can't stop.

Sorry, that wasn't @Claw, should have been @Dangermouse17.

@claw if it's tight, consider trying olive oil - it should help to make it a little more supple.

Hard to tell from your photo as my phone is rubbish, but is there a golden crusty scab across parts of the redness? Like impetigo?

Thank you De yes I agree internet diagnosis, not ideal! Just my GP doesn’t know what it is! Suggestions most welcome! Been 4 times now! I will definitely ask for a referral.

spart not patronising at all! I haven’t told him not to scratch, as you say even if I did, he would struggle not to!

sleep my son has had impetigo before! I actually asked my GP about this, when it looked infected.

When infected, it had crust on it. Now it looks more like burns. I’m pretty sure it’s not impetigo. They were more like blisters.

I’m sure it’s not impetigo or an allergy. It’s not like any eczema I’ve ever seen.

Any moisture on it, seems to make it much worse. I’ve googled and can’t find anything similar.

It looks like psoriasis.

Just seen your last post about looking like blisters. I'm sure this is psoriasis.

No! It’s not like blisters! It looks like burns.

Anyhow, I was hoping someone would say I’ve seen exactly the same. I have no idea, GP doesn’t know either.

I will ask for referral. Thanks everyone so much for your advice x

OP my 9 year old daughter has something similar and the GP was no help at all. She's seeing a dermatologist on Monday- I'll pass on any great words of wisdom!!