Is this eczema?

[imaginaryfriend]

I've been having troubles for a while with dd's skin. She's been diagnosed as having eczema since she was a baby (she's 4.6 now) although she's never really suffered with it on her body so much as having quite nasty flare-ups on her face which have always previously responded to antibiotic cream and hydrocortisone.

Now, for about 2 months she's had an awful flare-up around her mouth and eyes, especially her chin which is flame red all the time. But the worst part is her genitals. She's in such a lot of pain with it and I'm at a loss as to how to help.

I've been to the GP numerous times and tried strong HC creams, antibiotics, antifungals, all to no avail. We've got a dermatologist appointment coming up but not until 4 May which seems an age to wait when she's suffering so much. She wakes about 3 times a night and I have to put a barrier cream on her genitals as they hurt so much in the night. Plus when she wees she screams, at home and at school.

Her skin is very red and has little raised watery blisters on it, there are at least 20 of them on her genitals. The blisters sometimes break open and weep, that's when she's in the most pain.

Does this definitely sound like eczema? Someone suggested the herpes virus, in which case what would be a good treatment for it?

your poor dd
fingers crossed this will sort her out, and you are now at least under a consultant so one way or another this will get resolved

I so hope so. She's a gorgeous girl and it's not fair for her to be suffering like this. The other kids at school are commenting on her face a lot now. I could see her 'shirk' away from the consultant looking today which is the first time.

The new creams were a bit of a disaster. Dd's very good about being creamed and I put the stuff on her face, she had her medicine. I put the clotrimazole cream on, fine, then the Elocon on her genitals saw her go red in the face, screech, scream, and she was in such agony I washed it off and just put the clotrimazole on.

I'm going to do some googling now and see if I can work anything further out to help my little one.

Hi if. Was away this week which is why I haven't got back to this.

Crikey, I'm so sorry to hear about your dd and sorry that the creams haven't worked out. How is she now? At least she's being seen by the right person.

Btw, I remember at the time looking up all sorts of other rashes (think one might have been lichen planus - that may be wrong though, if it's some nasty sexually transmitted thing, please ignore it!) because it seemed so odd. TOUCH wood, we are still free of it and long may it continue. However, I imagine it will come back again at some point (it seems to do this).

Did the derm say anything about it possibly being herpes?

Hope she's feeling a little better by now.

Hi fox, I was wondering if you were around! I hope you've had a good week away?

We've been back to the GP tonight as dd can't tolerate any of the hydrocortisones on her genitals. She looked and says she's fairly sure it's not eczema so said to lay off them and just keep coating her in barrier creams (which is what I've been doing for about 6 weeks to no effect, in fact she's steadily getting worse ... ).

I don't know about herpes, nobody's mentioned it. We've had antifungal creams of various kinds though. And now she's on these long-term antibiotics I guess that would clear it if it were?

Nobody seems to think the soreness on her face is related to the soreness on her genitals. The consultant called her facial dermatitis 'perioral dermatitis' although it's 90% seen in adult women as a result of over-using face creams etc. The pictures of that condition are slightly similar to dd's problem except hers goes right up to her lips whereas that condition leaves an area clear around the mouth area. So really I'm flummoxed. Possibly the facial rash is due to the over-use of steroid creams which makes me mad as we've gone back and forth to the GP so many times and continually been given stronger steroid creams which may have actually been making it worse.

I'm at a loss, really I am. 5 weeks until we see the dermatologist again. If her face is perioral dermatitis then within 2-4 weeks of using the antibiotics we should see a difference. As for the genitals, nobody knows. Everybody cringes when they see it especially the 30 or so weeping pustules she has down there ...

A big and mighty AGGGGGAAAAAAAHHHHHHGGGGGGHHHHHH!!!

5 weeks ??!! gawd, you poor thing and poor dd. I've never heard of the face rash. Let's hope the antibs hit that.

Wrt to the herpes, I think it's like cold sores in that nothing actually works for it other than anti-virals (you know if you get a cold sore you get that zovirax stuff which is anti-viral - you can get pills too). This is what made me think of it with dd (and the weeping pustules) because nothing else had worked but I'm sure the derm would have picked that up. The other thing I thought was a type of psoriasis (but rare in children) - but I'm really clutching at straws and a pead derm, I'm sure, would have considered all the above.

What barrier creams are you using? I wonder if it would be worth calling the derm and telling him the creams aren't working - perhaps he could fit you in sooner?

and yes, thanks, we had a good time away.

I spent a day trying to phone the dermatologist but if you've ever tried to get through the endless hospital switchboard / voicemail system you'll know what I mean. There's no way I can speak to the doctor I saw, he will only take calls from a GP (my GP was angry too about this system) so I just got to speak to the on-call paed dermatologist who wasn't any help, largely because as he himself said he hadn't seen my dd's skin.

The consultant we saw asked us to come back in 3 weeks but they didn't have a slot, then the next week was a bank holiday (clinic on a Monday only), so it slipped into 5 weeks. I'm not happy about it at all. Especially as I'm left now with nothing whatever to put on her genitals apart from barrier cream. But possibly the antibiotics will make that area improve too? Who knows ... It's all very frustrating. i wish someone could just explain it all to me!

Nobody has mentioned herpes. I guess I should try to look for some images of it. I'll link you to the perioral dermatitis images which are most like what it looks like.

Could you run through your dd's story again for me if you don't mind? What made it go in the end?

I'm so depressed that dd's going to be taking antibiotics for at least 6 weeks. They give her rotten tummy ache on top of it all.

The images of perioral dermatitis are here - some aspects are like dd's face but it's not totally like her genitals, that's almost like it has small chickenpox (you know when they very first come up and are tiny blisters?) on.

let's hope the antibs have an effect on her genitals too . From your site, here's their run down of genital skin conditions - I was beginning to think dd had lichen simplex (though hers, in the end, after all the scratching, looked less like the pictures on there but more like lots of little blisters).

I can't remember how it started - it MAY have been after having worms (have you checked for that - it could be making it worse) but I think it just appeared randomly. She would scratch endlessly. First, I thought it was thrush (though no white stuff) so put canestan on. That didn't work, so I tried mild hydrocortisone but her itching was getting out of hand. Took her to the doc who prescribed canestan H (this was after taking her initially, right at the start and them telling me to put aqeous cream on it ). That did nothing and by now, I reckon she had been scratching for months. The more she scratched, the worse it got and then it seemed to develop into being v red with yellow lumps which then appeared to be blisters. Plastered her with diprobase day and night, gave her antihistamines for a few days (to try and stop the itching) and miraculously, it went away. GP friend suggested it might have been impetigo but it wasn't really yellow enough iyswim.

I say miraculous because I really do not know why it went away. This isn't the first time we've had it. It's happened twice (I think) and each time it has lasted months and months.

Wrt blisters - I get a weird (as yet undiagnosed) rash on my elbows, knees and fingers. It is VERY itchy (I initially thought it was this and this is quite similar to what dd had but I'm not coeliac). IF I scratch it hard (and I try not to), I develop little blisters so I think (though don't know) that the blisters dd developed MAY have been as a result of the scratching rather than part of the rash (iyswim).

I really don't know . What a pain about the consultant - perhaps writing him a letter would help, even if you can't get to see him, at least you've communicated the problem (although you'd hope that the other guy you spoke to would have done that).

Does dd like yoghurt? I think that helps protect the tum when they have antibs. At least if they sort out her rash it will probably be better than plastering those extra strong steroids on all the time.

Fox, dd's genitals look vaguely similar to the bottom right picture of the six on the lichen simplex page but not totally the same. Also, unlike your dd, she rarely scratches down there. Maybe in the night she does and that's why it gets particularly sore but during the day time I very very rarely see her scratching. I almost think it's too sore for her to scratch. Mostly she just describes being sore. If your dd's problem was lichen simplex you may have done the perfect thing by giving her piriton and stopping the itch / scratch cycle. It'll be interesting to see if she gets the problem again and the same remedy works! Actually I might try some piriton on my dd tomorrow night, just in case it stops her scratching at night in any case ...

I haven't been able to get her to tolerate any creams whatsoever apart from barrier-type creams on her genitals. And she's still calling me in 2-3 times a night to put more cream on as she's so sore.

But her face is definitely looking a bit better. I don't think I"m imagining it even though it's a bit early for the antibiotics to be meant to have any effect. It's looking pinker rather than red and it's not quite so raised. Also over these last few weeks it's got steadily worse every day and it definitely hasn't got worse at all over this week. So fingers crossed there ...

I had eczema as a child which made life very miserable as it was most extreme on my face. I remember being given such a huge cocktail of creams over the years and then when I hit puberty it suddenly got tons worse and then miraculously disappeared overnight. I remember I was so shocked that I kept on putting on cream on the places where it'd been for ages because I couldn't believe it had finally gone!

It's good to chat to you about this, fox. Thanks again.

how's her face doing now? so pleased to hear it's starting to look a bit better - let's hope it starts to have a positive effect on her sore bits too

Hi fox. I don't know if it's really looking better any more or if I'm wishing it to! This morning her face looked awful. No change with the genitals but I think with both I have to be patient for another week and see how it pans out.

How's your dd?

well, unfortunately, when we got to school this morning, she took me aside and said her bits were very sore . Obviously, she chose to tell me about this 2 minutes before she was due to go in so there was nothing I could do about it! I asked her if she thought we needed to put cream on again and she said it felt like that . Please, please, please don't let it be the rash.

She had a vomiting bug over the weekend - well I thought it was a bug - very very high temp (40C+) but weirdly, NONE of us have come down with it. Now, I'd like to think it's due to hand washing and hygiene but in reality, we're quite crap at all of that and normally, we would have all come down with it so I'm wondering whether she may have a UTI. She seems better though - so maybe it's washed itself out? I don't know.

I'll see how she is when she's back from school.

And grrr for your poor poor dd. When is your next appointment did you say?

The next appointment isn't until the beginning of May. But the GP is being very helpful, we're seeing her again on Friday and she's going to phone the consultant as apparently they will 'accept' calls from GPs but not their patients ... Grrrrr!!! My GP was cross about it too.

My dd's currently got a horrible tummy bug and isn't keeping anything down so I'm unable to give her the antibiotics. The truth is, she is slightly better on her face but nowhere near properly better, just a shade better. Her other bits are exactly the same.

Oh dear, not great news for your dd - I hope it turns out to be nothing ... Can you remind me how old she is again? I somehow have her in my mind as the same age as mine (4-and-a-half) but that's probably solipsistic thinking!

she's 6 - will be 7 this year. I think the first time we had the problem was around your dd's age.

How fantastic that the GP is being supportive. Makes all the difference.

Ah ... that's why I thought she was the same age. So it's been coming and going all that time?

yes, unfortunately. Actually, I feel a bit bad because I really gave up on going to the doctor when they couldn't come up with anything that helped (after trying and trying). And then of course, it seemingly disappeared of its own accord (and if I go back and tell the doctor that, they'll just tell me to wait until it does the same thing again!).

did they never refer you to a dermatologist?

No, they were never that interested. Tbh, hers never looked really bad till right at the end - and just as it was looking at its worst, it disappeared. When it seems to irritate her the most, is when it is all lumpy but not obviously inflamed iyswim.

First time I went to the docs, they didn't even examine her. Honestly. THey just sent me away with aqueous cream. Second time, they wrote a script for Canestan H without even having a look. I actually had to order dd onto the bed thing and told her to get undressed and even then, the doctor looked at me as if I was mad.

I hate doctors (apologies to all those who are ). I don't like being messed around. I want answers when I go in and if they don't know, I just want to know that they don't know (iyswim) - I wouldn't be pissed off if they just held their hands up and said 'tis beyond us' but to blindly send us away with cream without looking makes me maaaaaaaaad.

I don't blame you being mad. Aqueous cream for goodness sake?! It wouldn't touch something like this. And as for Canesten, dd's been given it twice and the dermatologist said that small girls very very rarely need anything like that.

I know what you mean about not being taken seriously though. I was taking dd back and forth for quite a while and being given stronger and stronger combinations of creams for her face and genitals and it steadily got worse. I asked ot be referred to a dermatologist half a dozen times and I wish now I'd insisted more angrily because it turns out that the amount of steroids she's had on her face will definitely have been making the problem worse.

However, we do have one good GP. But she's very hard to get an appointment with, always booked for weeks, and never does the emergency surgery.

How's your dd doing by the way? Was it something or nothing?

My dd's thrown up her antibiotics for the last two days and I can tell the difference in her skin. So they must have been doing something!

we have the same (the one GP who is good and who you can never get an appointment with!).

she didn't let me look because we had people round yesterday but she didn't complain about it and she hasn't been scratching so fingers crossed....it may be because we don't have a loo at the moment (building work) so we've all been holding on longer than we normally would!

She's got swimming tonight so I'll get a good idea then.

Glad the antibiotics are doing some good - hope you don't come down with the vomiting!

Dd sees the good GP tomorrow afternoon when she's promised to run through the dermatologist's letter - assuming she's got it by now, these things are so slow. I'm actually going to ask her if we can change the antibiotic as I think it's upsetting dd's tummy and if she's got to take it for months it seems a bit unfair. The problem is that dp has to take her to GP as I'm at work tomorrow so I've written him a list of questions to ask. He's very well-meaning but is a bit scatty about these things so I know I won't be satisfied. It was the only appointment for 2 weeks that she could give us.

fingers crossed it's gone OK today (and lol at your dh and his list - that's exactly what I would have done!).

Men are pretty crap sometimes aren't they? I gave dp such strict instructions today too to avoid him getting dd's bug only to come home and find them sharing a bottle of orange juice, both drinking from the bottle ... He must want this damned bug!

The GP couldn't see any change in dd's rashes from last week but it's definitely deteriorated since she's been off the antibiotics. I'd put on my list for dp to ask her if there was an alternative antibiotic as the one she's had has definitely seen her off her food and she offered a penicillin. But for some inexplicable reason Dp told her dd was allergic to penicillin (which she's not, I am [grrrr]) so he's come home with more bloody eurythromycin.

Now she seems to have stopped throwing up - a mammoth session which has lasted from Tuesday morning until yesterday evening - I'll put her back on the antibiotics and see how it goes again.

GP hadn't received the letter from the consultant yet so she didn't know who to contact. I can't remember his name, we saw one of the registrars, not the consultant whose name headed the clinic, and he was Japanese with a very complicated name. So she doesn't know who to phone.

All a bit frustrating. It's been a bit of a week.

How's your little lady doing?