Strange rash

[Jason Wagner]

Hi gang,

My three-year-old son has had a very persistant rash for the past two days.

Yesterday morning my wife alerted me to pea-sized red bumps on my son's arms
and legs, and a very swollen and red left ear. I thought initially he must
have been bitten by a spider on the left ear, and we put in a call to our
doctor. While we were waiting for him to call back, the rash spread rapidly
into half-dollar-sized red blotches with irregular borders, and his right
ear grew swollen and red. I gave him 1/2 tsp of Benadryl, and within 15
minutes the symptoms began to fade. After an hour they were gone entirely.
He was in no pain, he did not itch. Our doctor said he treated a boy the
previous day for the exact same thing; the boy had eaten peaches (my son had
also eaten peaches that day).

Later on in the day the symptoms came back with a vengence. No swelling on
the ears, but his cheeks each got large red raised spots, and so did his
arms and legs (to the point where most of his left leg was covered; the rash
wrapped around his legs and arms). We called the doc again and he told us
that its not unusual for the symptoms to return while his body works the
allergen/whatever out of his system. He recommended Chlortrimatron, so I
gave him 3mg of that. It worked slowly, but within two hours the symptoms
were fading. When we put him to bed, he was completely fine.

This morning he had a tiny bump on the back of his arm. After about six
hours, he had a few more bumps on his arms and legs. A few hours later he
had the rash all over his face, arms, and legs again. I gave him a full
teaspoon of Benadryl, and about an hour later the symptoms appear to be
fading. He had no peaches today.

My son has eaten peaches from the time he could first sit up, so I'm
inclined to think he's not allergic to them. He's not eaten anything
different than he normally does, and its been hot, muggy, and rainy here, so
he hasn't spent much time outdoors lately (for exposure to insect bites
etc). Still, this is Az, and we get plenty of critters crawling around the
house. He has no obvious open sores, bite marks, or puncture marks on his
body. It does not look like he's been bit, brushed up against something,
stepped on something sharp, etc. If anything it appears to be something
he's eaten, although as I said, his diet lately has been no different than
usual.

Any ideas what this could be? The rash, when present and at its worst, has
very pink, pronounced edges, lighter pink interiors, and are irregularly
shaped. They're very blotchy and raised, and cover everything except his
trunk (they're virtually non-existant on his trunk and the soles of his feet
and hands). He's had a slight fever for about 4 days now, something we
figured he picked up from his cousins and completely unrelated to the rash.
The fever comes and goes. Maybe the two are connected?

Any advice would be appreciated. I am convinced that his body fighting off
some sort of allergen or venom, but I really hate to see it be a long
process.

Thanks.

[Tsu Dho Nimh]

"Jason Wagner" > wrote:

>Hi gang,
>
>My three-year-old son has had a very persistant rash for the past two days.

>ear grew swollen and red. I gave him 1/2 tsp of Benadryl, and within 15
>minutes the symptoms began to fade.

>Any ideas what this could be? The rash, when present and at its worst, has
>very pink, pronounced edges, lighter pink interiors, and are irregularly
>shaped. They're very blotchy and raised, and cover everything except his
>trunk (they're virtually non-existant on his trunk and the soles of his feet
>and hands). He's had a slight fever for about 4 days now, something we
>figured he picked up from his cousins and completely unrelated to the rash.
>The fever comes and goes. Maybe the two are connected?
>
>Any advice would be appreciated. I am convinced that his body fighting off
>some sort of allergen or venom, but I really hate to see it be a long
>process.

Maybe something contaminated his pillow or sheets:

Caterpillars? I forget which one, but AZ has a caterpillar with
extremely irritating hairs.

Cow-itch tree? (AKA bottle tree ... the one with the seedpods
that have reddish seeds covered in orange hairs) The hairs are
extremely irritating.

Fire ants? Those tiny red ones have a bite that does make the
bite site swell up again and need treatment for several days.

Antihistamine or cortisone ointment works against all three.

Change the sheets, mattress pad, pillows and pillowcases. Wash
them in hot soapy water.

Keep him on the benadrly or Chlortrimetron for a few days until
it goes away


Tsu

--
To doubt everything or to believe everything
are two equally convenient solutions; both
dispense with the necessity of reflection.
- Jules Henri Poincaré

[Kara Tyson]

Is there any chance that this could be Rocky Mountain Spotted Fever or
Ehrlichiosis??!

Kara Tyson
Lyme Disease Support Group of AL

Serving patients with tick diseases:
Lyme Disease
Babesiosis
Colorado Tick Fever
Ehrlichiosis
Relapsing Fever
Rocky Mountain Spotted Fever
Tick Paralysis
Tularemia
Q Fever
Bartonella
Master's Disease
West Nile
Hept. C

[PF Riley]

On Sat, 16 Aug 2003 22:38:35 -0700, "Jason Wagner" >
wrote:
>My three-year-old son has had a very persistant rash for the past two days.
>
>Yesterday morning my wife alerted me to pea-sized red bumps on my son's arms
>and legs, and a very swollen and red left ear. I thought initially he must
>have been bitten by a spider on the left ear, and we put in a call to our
>doctor. While we were waiting for him to call back, the rash spread rapidly
>into half-dollar-sized red blotches with irregular borders, and his right
>ear grew swollen and red. I gave him 1/2 tsp of Benadryl, and within 15
>minutes the symptoms began to fade. After an hour they were gone entirely.
>He was in no pain, he did not itch. Our doctor said he treated a boy the
>previous day for the exact same thing; the boy had eaten peaches (my son had
>also eaten peaches that day).
>
>Later on in the day the symptoms came back with a vengence. No swelling on
>the ears, but his cheeks each got large red raised spots, and so did his
>arms and legs (to the point where most of his left leg was covered; the rash
>wrapped around his legs and arms). We called the doc again and he told us
>that its not unusual for the symptoms to return while his body works the
>allergen/whatever out of his system. He recommended Chlortrimatron, so I
>gave him 3mg of that. It worked slowly, but within two hours the symptoms
>were fading. When we put him to bed, he was completely fine.
>
>This morning he had a tiny bump on the back of his arm. After about six
>hours, he had a few more bumps on his arms and legs. A few hours later he
>had the rash all over his face, arms, and legs again. I gave him a full
>teaspoon of Benadryl, and about an hour later the symptoms appear to be
>fading. He had no peaches today.
>
>My son has eaten peaches from the time he could first sit up, so I'm
>inclined to think he's not allergic to them. He's not eaten anything
>different than he normally does, and its been hot, muggy, and rainy here, so
>he hasn't spent much time outdoors lately (for exposure to insect bites
>etc). Still, this is Az, and we get plenty of critters crawling around the
>house. He has no obvious open sores, bite marks, or puncture marks on his
>body. It does not look like he's been bit, brushed up against something,
>stepped on something sharp, etc. If anything it appears to be something
>he's eaten, although as I said, his diet lately has been no different than
>usual.
>
>Any ideas what this could be? The rash, when present and at its worst, has
>very pink, pronounced edges, lighter pink interiors, and are irregularly
>shaped. They're very blotchy and raised, and cover everything except his
>trunk (they're virtually non-existant on his trunk and the soles of his feet
>and hands). He's had a slight fever for about 4 days now, something we
>figured he picked up from his cousins and completely unrelated to the rash.
>The fever comes and goes. Maybe the two are connected?

They probably are. You are describing a very typical presentation for
acute urticaria (hives). Some people typically first think of allergy
with hives because that's what typically causes them in adults.
Children, however, most commonly get hives as a reaction to a viral
infection. The viral infection may manifest as a typical cold, a mild
fever for 3 to 4 days perhaps with intestinal symptoms, or may in fact
have no symptoms at all except for the hives.

Hives tend to be irregularly shaped, relapsing, raised lesions that
are usually very itchy (although small children often don't seem
bothered as much by what would usually be a maddeningly itchy rash in
an adult) and may completely disappear with Benadryl, only to return
when the medicine wears off. They are usually symmetrically
distributed anywhere on the body and last about a week or so before
going away on their own.

>Any advice would be appreciated. I am convinced that his body fighting off
>some sort of allergen or venom, but I really hate to see it be a long
>process.

Spiders are blamed for mysterious rashes and sores much, much more
often than they should be. Hives from food allergies typically don't
last for several days, either. While you can't conclude he's not
allergic to peaches simply because he's tolerated them before (one may
become sensitized to something previously tolerated at any time), I
would say it's safe to conclude your son is not allergic to peaches.
If one goes on enough of a "fishing expedition," one can often
accidentally find something to blame for the urticaria which is not
likely the culprit, even when a symptom (fever) of the true cause
(viral infection) has been there all along.

Family physicians are more likely to blame hives in small children on
a recently consumed food as some of them unfortunately tend to think
of children as small adults. I typically see clusters of children with
virus-induced urticaria, as he may have as well given the case from
the prior day, not only because of the natural clustering that occurs
with random events but because at any of these times there is likely
an urticariogenic virus circulating in the community.

PF

[Wendy Marsden]

PF Riley wrote:
> Children, however, most commonly get hives as a reaction to a viral
> infection. The viral infection may manifest as a typical cold, a mild
> fever for 3 to 4 days perhaps with intestinal symptoms, or may in fact
> have no symptoms at all except for the hives.

Thanks for mentioning that. It makes perfect sense but wasn't something I
had known before and explains a mysterious rash in one of my boys a few
years ago.

It took me a LONG time to realize that my sons had viral-triggered asthma
- I kept looking for a trigger that wasn't there. Now it is so damn
obvious, but I wasted years (and over-medicated my oldest son) before I
figured this out.

I know that allergies, eczema and asthma are linked, so hives in a kid who
has asthma doesn't seem like a stretch.

Wendy, learning something new everyday

[PF Riley]

On Sun, 17 Aug 2003 22:28:10 GMT, Wendy Marsden
> wrote:

>PF Riley wrote:
>> Children, however, most commonly get hives as a reaction to a viral
>> infection. The viral infection may manifest as a typical cold, a mild
>> fever for 3 to 4 days perhaps with intestinal symptoms, or may in fact
>> have no symptoms at all except for the hives.
>
>Thanks for mentioning that. It makes perfect sense but wasn't something I
>had known before and explains a mysterious rash in one of my boys a few
>years ago.

No problem. Hives in adults can be from viruses, too. Last year in May
I got a cold and actually wheezed a little on a Sunday evening (I have
mild seasonal allergic rhinitis but I am not asthmatic.) The next
morning I was covered in urticaria. I remember looking at myself in
the mirror that morning thinking, "Geez I'm glad I know what this is
or I'd be freaked out!" (I had a renewed understanding of parents who
call in frantically about rashes.) I loaded up on antihistamines and
went to work, where I subsequently saw three kids with viral illnesses
and urticaria that morning, and a few more during the rest of the
week.

Another cause of mysterious rashes associated with viral infections in
kids are viral exanthems, which are also rashes in association with
viral infections but have different morphologies from urticaria and
usually do not itch.

>It took me a LONG time to realize that my sons had viral-triggered asthma
>- I kept looking for a trigger that wasn't there. Now it is so damn
>obvious, but I wasted years (and over-medicated my oldest son) before I
>figured this out.

Viral illnesses are the most common cause of asthma exacerbations.

>I know that allergies, eczema and asthma are linked, so hives in a kid who
>has asthma doesn't seem like a stretch.

Usually all three conditions are sprinkled liberally amongst atopic
families, with some family members unlucky enough to get the hat
trick. I'd be interested to know if atopic kids are more likely to get
virally induced urticaria, or if it occurs with equal frequency in
nonatopic kids.

PF

[Tsu Dho Nimh]

(Kara Tyson) wrote:

>Is there any chance that this could be Rocky Mountain Spotted Fever or
>Ehrlichiosis??!

Not in Arizona ... we don't have the right kind of ticks.



Tsu

--
To doubt everything or to believe everything
are two equally convenient solutions; both
dispense with the necessity of reflection.
- Jules Henri Poincaré

[Tsu Dho Nimh]

(Kara Tyson) wrote:

>Is there any chance that this could be Rocky Mountain Spotted Fever or
>Ehrlichiosis??!

Not only does AZ not have the right kind of ticks, RMSF and
Ehrlichiosis are NOT going to have that kind of a rash and will
NOT clear up with Benadryl.



Tsu

--
To doubt everything or to believe everything
are two equally convenient solutions; both
dispense with the necessity of reflection.
- Jules Henri Poincaré

[Tsu Dho Nimh]

(PF Riley) wrote:


>No problem. Hives in adults can be from viruses, too. Last year in May
>I got a cold and actually wheezed a little on a Sunday evening (I have
>mild seasonal allergic rhinitis but I am not asthmatic.) The next
>morning I was covered in urticaria. I remember looking at myself in
>the mirror that morning thinking, "Geez I'm glad I know what this is
>or I'd be freaked out!" (I had a renewed understanding of parents who
>call in frantically about rashes.)

What's the etiology? Immune system running amok and cranking out
too much histamine?



Tsu

--
To doubt everything or to believe everything
are two equally convenient solutions; both
dispense with the necessity of reflection.
- Jules Henri Poincaré

[Wendy Marsden]

PF Riley wrote:

> No problem. Hives in adults can be from viruses, too. Last year in May
> I got a cold and actually wheezed a little on a Sunday evening (I have
> mild seasonal allergic rhinitis but I am not asthmatic.) The next
> morning I was covered in urticaria. I remember looking at myself in
> the mirror that morning thinking, "Geez I'm glad I know what this is
> or I'd be freaked out!"

Interesting. I get hives with nearly every antibiotic. I've gotten to
the point where I just take the best choice antibiotic and take benedryl
at the same time. I've never had a severe allergic reaction to any of the
antibiotics, and realize that I'm in danger of getting one, but I've
gotten thoroughly sick of getting an antibiotic NOT on my "do not
prescribe" list and still getting hives, changing the prescription and
STILL getting hives, etc. I've got an epipen and live .3 miles from the
hospital. I'll take my chances.

But now I wonder if it's not the medicine giving me hives, but the
underlying illness that is being treated with the antibiotics. (Yes, I
understand that viruses ought not be treated with antibiotics, but the
time I've been thinking of we weren't sure whether it was viral or
bacterial.)

By the way, I've got the "hat trick". Mild allergies, moderate eczema and
viral-triggered asthma. I tend to get hives easily. I've noticed that my
few food allergies can manifest in nearly any form: a runny nose, an itchy
finger or wheezing.

By the way, I'm not whining: everything is quite manageable. It's just
interesting to consider that the hives might not mean I can't ever have
that antibiotic again.

Wendy

[CBI]

"Kara Tyson" > wrote in message
om...
> Is there any chance that this could be Rocky Mountain Spotted Fever or
> Ehrlichiosis??!
>
> Kara Tyson
> Lyme Disease Support Group of AL
>

Have you ever met anyone that you didn't think had Lyme disease?

[PF Riley]

On Mon, 18 Aug 2003 23:39:10 -0400, "CBI" >
wrote:

>"Kara Tyson" > wrote in message
om...
>> Is there any chance that this could be Rocky Mountain Spotted Fever or
>> Ehrlichiosis??!
>>
>> Kara Tyson
>> Lyme Disease Support Group of AL
>
>Have you ever met anyone that you didn't think had Lyme disease?

When all you have is a hammer...

PF

[PF Riley]

On Mon, 18 Aug 2003 04:50:27 -0700, Tsu Dho Nimh
> wrote:

(PF Riley) wrote:
>
>>Children, however, most commonly get hives as a reaction to a viral
>>infection. The viral infection may manifest as a typical cold, a mild
>>fever for 3 to 4 days perhaps with intestinal symptoms, or may in fact
>>have no symptoms at all except for the hives.
>
>Interesting ... I didn't know that. Don't remember it from
>virology either.
>
>It also explains a lot of "food allergies" that never cause any
>problems again.

It also explains why only about 4% of adults who think they are
allergic to "penicillin" actually are. It's from back in the day when
kids got antibiotics for all colds. Sooner or later, one of those
colds would cause urticaria while the child was taking amoxicillin and
voila, he's branded "allergic."

PF

[Kara Tyson]

> >
>
> Have you ever met anyone that you didn't think had Lyme disease?
_________
Uh..yeah.

That's why I said Rocky Mountain.

What an odd question.

Kara

[Kara Tyson]

the "symptoms" also are supposed to have a rash..yet I have met
someone with Rocky Mountain who did not. People are differant.