Name that weird kid rash?

[lessel]

Have we had a round of this game in awhile?

I noticed DS (8.5y) had weird streak on his thigh a couple days ago. It’s gotten raised, bumpy, and itchy over the course of the next couple days. We’ve alternated aquaphor and cortaid and neither seems to help. Yesterday noticed a small similar spot on his collar bone and today it’s worse. He says both are itchy and pointed out a small spot on his arm that seems to be heading in the same direction as the others.

He’s got a neurologist/sleep doc appt tomorrow, so soonest I can get him to his regular doc is probably Wednesday. We had a weird bout with a mystery rash year before last I think… initial dx was Gianotti Crosti, then a derm said no it was eczema or psoriasis, no treatments worked, and so on to a second derm who said it was indeed Gianotti Crosti. It was months and months with that rash so DS is already anxious about this one, poor kid.

Pics hidden if I did this correctly…

SPOILER: Click to show

Collarbone yesterday vs. today

[cmeon]

Hm. It looks like (not a doctor)- lichen striatus. It's the interesting rash pattern- the rash lines follow the lines of Blaschko (a quirk which is the only reason I know about it, no personal experience, sorry- it's just an oddity).

If it is that, it's generally another harmless immune reaction that he just has to get past. Poor little guy, I hope you're able to get answers (and itch relief) soon!

[lessel]

Nov 27, 2023 20:19:53 GMT -5 cmeon said:

Hm. It looks like (not a doctor)- lichen striatus. It's the interesting rash pattern- the rash lines follow the lines of Blaschko (a quirk which is the only reason I know about it, no personal experience, sorry- it's just an oddity).

If it is that, it's generally another harmless immune reaction that he just has to get past. Poor little guy, I hope you're able to get answers (and itch relief) soon!

After googling it does look like that. And of course it says it takes several months to go away. I’ll get him into the doc soon to confirm.

This poor kid. Why is he getting these strange untreatable rashes?!

[lessel]

Ugh. I’m getting him into the doc today. The collarbone/neck spot wrapped onto his ear. Now he has another spot on his cheek (other side of his face) that went from nothing to really red and a new one on his back.

Wtf

[cmeon]

There are a few other skin conditions that run along Blaschkos's lines, so definitely get it looked at, and I sincerely hope it's just a weird presentation of eczema or something "easy". I'm really sorry, this has to be especially tough on both of you coming off the last mystery rash experience. Fingers crossed that he's diagnosed much more quickly and that there's a fast and effective fix.

[meowmaps]

Is it possible it’s an allergic reaction to something? Bear with me. Not kid-related, but I had a random, weird, itchy rash on various spots on my body in September and it looked similar to your son’s rash. Long story short, I was having an allergic reaction to Bounce dryer sheets. We hadn’t used dryer sheets in years and are generally pretty conservative when it comes to using anything with fragrances, etc. because I have sensitive skin and DD2 has eczema. Our dryer was getting stinky though so my H picked up a pack and we started using them. When we retraced our steps and looked at the timeline of using the dryer sheets and the appearance and then proliferation of the rash, it added up. Is there something new that’s been introduced to his environment? Just a thought.

[lessel]

Went to our new pediatrician. I hate feeling like we're stumping a doc. He's not sure about lichen striatus--says he's more familiar with that being in one spot... not this migrating, spreading everywhere situation. Whatever is going on is making his skin highly reactive... the doc drew a line on his skin that got red and stayed that way through the visit. So he wants to start an oral steroid to try to calm down whatever systemic reaction is happening.

We haven't changed anything with detergents or soaps or anything... everything we use is pretty mild because DH has pretty sensitive skin.

[Deleted]

Is it only on one side of his body?

It doesn’t look like eczema or contact dermatitis to me.

I’d actually take him to a dermatologist rather than the pedi for something like that. Pediatricians are great, but they aren’t specialists. If he was stumped I’m actually surprised he didn’t refer you to derm before treating anything.

The fact that it is linear seems like it’s definitely worth a dermatologist visit.

[lessel]

Nov 28, 2023 10:47:45 GMT -5 @mrsgreeko said:

Is it only on one side of his body?

It doesn’t look like eczema or contact dermatitis to me.

I’d actually take him to a dermatologist rather than the pedi for something like that. Pediatricians are great, but they aren’t specialists. If he was stumped I’m actually surprised he didn’t refer you to derm before treating anything.

The fact that it is linear seems like it’s definitely worth a dermatologist visit.

It's bilateral. Right side has face (cheek), forearm, back, thigh. Left side has neck, ear. But really he's now getting little red spots almost everywhere... there are a couple spots near his nose, behind both knees.

I think I'm going to call the derm too. Just with his weird history... I don't like unsolved mysteries. 

ETA a couple more pics

SPOILER: Click to show

[cmeon]

How is he doing today, lessel ? His skin looks pretty furious about something in the photos- were you able to make an appt. With a derm? I know it's not easy to have visible rashes (let alone itchy ones!), so my heart goes out to him. I hope whatever is going on is short-lived.

[lessel]

Nov 29, 2023 12:51:44 GMT -5 cmeon said:

How is he doing today, lessel ? His skin looks pretty furious about something in the photos- were you able to make an appt. With a derm? I know it's not easy to have visible rashes (let alone itchy ones!), so my heart goes out to him. I hope whatever is going on is short-lived.

So he got 2 doses of oral steroids in yesterday and I gave him some liquid Benadryl at bedtime. This morning it looked a bit less angry and red/raised, but it’s more spread out and new spots have popped up. And some of the original spots are turning purple. This afternoon it’s more of the same. Couple new spots popped up, existing spots are more diffuse.

We have a derm appointment tomorrow morning. I almost wonder if we need some other kind of specialist that can give us some insight on the potential immune system whatever that might be triggering these. The 6-month rash in 2021 plus this makes me feel like we need to dig deeper. Maybe that’s a rheumatologist? I dunno.

[Poppy]

I'm glad you're getting into a derm, and I agree that a rheumatologist might be a good next step if the derm can't give you a good answer.

Sorry, I wish I could actually help. I feel bad for him!

[Jalapeñomel]

Oh my goodness, your poor baby. I hope you get some answers soon; he must be miserable.

[momin2013]

Glad you have an appointment - geez, the poor guy, that’s so frustrating, and, I’m sure, irritating for him. Hope you get some answers and a treatment soon!

[lessel]

No fucking answers at the derm. I really wanted to see the derm we liked last time, but she didn't have open appointments until MARCH so I went with another dude at her practice. Not helpful. He's says it's definitely "weird" but is convinced DS got into something outside and this whole thing is an allergic reaction. Despite me telling the guy that DS was literally indoors for like 4 days straight before this thing started. He also said the body doesn't produce things in lines that they come from an external source (which, after going down the rabbit hole on lichen striatus, is just not true?). Although I also don't think it's that because it continues to spread and is not consistently in that line pattern. Derm wants me to put a strong steroid ointment on it 4x/day. No dude. I'm not putting it basically all over his body including on his face and around his eyes. Just, no. He still has scarring and discoloration on his knees and elbows from a bunch of fucking steroid creams in 2021.

I'm calling back his new pediatrician to chat some more.

[beerlover]

I'm sorry you are dealing with this! I agree with the rheumatologist suggestion. My brother had similar skin issues as a child and it took a long time to figure out but the cause was an autoimmune disorder.

[wanderingback]

Nov 30, 2023 10:38:25 GMT -5 lessel said:

No fucking answers at the derm. I really wanted to see the derm we liked last time, but she didn't have open appointments until MARCH so I went with another dude at her practice. Not helpful. He's says it's definitely "weird" but is convinced DS got into something outside and this whole thing is an allergic reaction. Despite me telling the guy that DS was literally indoors for like 4 days straight before this thing started. He also said the body doesn't produce things in lines that they come from an external source (which, after going down the rabbit hole on lichen striatus, is just not true?). Although I also don't think it's that because it continues to spread and is not consistently in that line pattern. Derm wants me to put a strong steroid ointment on it 4x/day. No dude. I'm not putting it basically all over his body including on his face and around his eyes. Just, no. He still has scarring and discoloration on his knees and elbows from a bunch of fucking steroid creams in 2021.

I'm calling back his new pediatrician to chat some more.

Dermatologists are great and I’m not knocking them at all (one diagnosed one of my patients with a rare cancer when I couldn’t figure it out, thank god for derm!). But I was really surprised when I did my month long rotation with them during training and a lot of the time they didn’t know and so would just recommended steroids. I thought I was being "dumb" with my patients when I would say not sure, try steroids, but come to find out dermatologists do that all the time, ha. I thought they had an answer for "everything."

The body is fascinating and has many mysteries. Since this has been an ongoing thing it seems like it’d be a good idea to seek the help of a rheumatologist and allergist to see if there’s anything systemic going on that they might want to rule out. I know its hard to get in with specialists but hopefully someone can see you all.
I hope you get answers.

[lessel]

wanderingback I was just lamenting to my colleague who is a former ED doc and she essentially said the same thing about derm. I wouldn't be so miffed about it if we hadn't already been down this road of multiple docs and steroids before. I guess ultimately my frustration is that he was just incurious about what is going on. Tbh, we had a somewhat similar experience with a sleep doctor earlier this week... first stop is throwing meds at my kid vs. trying to dig deeper and I just don't love that approach.

[turboteal]

I was also going to suggest an allergist, I had a bad outbreak of hives several years back that a general urgent care doc and derm couldn't help with (rx'd steroids and various topical meds respectively that didn't help) but an allergist got me on a winning combo (I think it was cimetidine and fexofenidine?) that finally gave me relief after a week of all over my body, constantly appearing/worsening and regressing hives. Never figured out the cause (viral maybe?) but it did not come back after I finished the course of meds the allergist gave me.

[macmars45]

Your poor kiddo! I'm so sorry he and you are going down this road again. I hope you can get some actual answers soon.

The allergist we had in town was amazing! He was so helpful with my DS! So helpful my H finally got an allergy workup himself (he's allergic to most trees, grasses, bushes and cats & dogs).