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Post by Bjs04f on Aug 10, 2015 15:21:46 GMT -5
year old F, sudden onset rash. Rash is non painful, does not itch. Pt eating and drinking well. Afebrile, no N/V/D. pt has no other complaints, otherwise well appearing on exam. Pt has no medical history, allergies, meds, is UTD on shots. No precipitating changes or events. Heres initial photo, Il show you the progression as you guys add or do things.  |
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Post by pbruss on Aug 11, 2015 19:02:11 GMT -5
i hate rashes like everyone else. just off the bat nothing looks or sounds too crazy. i would like to see or know more about that spot on her left arm.
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Post by Bjs04f on Aug 11, 2015 21:26:48 GMT -5
good you did nothing, now day 2   |
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Post by Bjs04f on Aug 11, 2015 21:28:32 GMT -5
 Oh shit son, by doing nothing kid 2 has this!!!!!!!! It becoming an epidemic. BTW heres what Peds Ed doc said "spider bite" Both kids different days odd. Derm says" Spider bite infected with poison oak!" Told fmaily to wash everything as blisters contain posion oak poison. Solid work specialist. Anyone else have thought |
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Post by pbruss on Aug 11, 2015 23:24:20 GMT -5
wait, so second kid in the same family has the rash now? same thing? acute onset, no pain or itching ect?
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Post by pbruss on Aug 11, 2015 23:28:22 GMT -5
want to know more about the history. where have thses kids been? what have they been around? travel? chemicals? house beong remodeled?
i take it from the pictures this is someone you know, all the background is not hospital
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Post by Bjs04f on Aug 12, 2015 9:24:19 GMT -5
Both kids same house, acute onset, no new chemical or changes around the house. No bug bites or other exposures as far as they know. Rashes are itchy, not painful, no mucosal involvement. No other symptoms. Yeah this came from a family friend, the quotes are from actual Peds EM and peds derm physicians.
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Post by jpollock on Aug 12, 2015 15:39:37 GMT -5
Initially thought about dermatomyositis or some autoimmune disease, but usually that shouldn't affect 2 siblings simultaneously. I know its extreme, but what about anthrax, mucor or some sort of fungal thing?
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Post by Bjs04f on Aug 12, 2015 17:40:51 GMT -5
no other symptoms of anthrax exposure, too many days without complications, and no escar formation. The sbilings rash is now diffuse maculopapular rash with no improvement on steroids or benadry. Kid 1 is on kelfex and mupirocin with resoluction of symptoms. My working diagnosis for her from beginning was impetigo or some staph/strep infection due to the crusting on initial lesion and it responded well to abx
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Post by drizsak on Aug 16, 2015 5:28:23 GMT -5
I am going with "Black Spot Poison Ivy" Kurlan JG, Lucky AW. Black spot poison ivy: A report of 5 cases and a review of the literature. J Am Acad Dermatol. 2001;45(2):246-9. Schram SE, Willey A, Lee PK, Bohjanen KA, Warshaw EM. Black spot poison ivy. Dermatitis. 2008;19(1):48-51. www.medscape.com/viewarticle/572966_2 |
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Post by Bjs04f on Aug 16, 2015 22:50:27 GMT -5
Yeah that was the final diagnosis, both imprved with steroids for the past week. Really odd looking rash
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