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Dermatology  (Expert Forum)
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Strange rash that our pediatrician can't diagnose
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.

Strange rash that our pediatrician can't diagnose

by Monya, Sep 11, 1999 12:00AM
My six year old son began a month or so ago with frequent urination. A week later he was throwing up and having diarrhea. This past week he had cold symptoms which I thought were allergy and sent him to school. This past weekend he developed a fever of 104 and developed a pimply looking rash on his face. It is red and soon spread down the top of his arms. His tonsils were very swollen with pus on them.  He also had his lips swollen as well as his tongue. The doctor's are dumbfounded and ruled out strep and the CBC showed a normal white count.  This rash has been here now for 8 days and is all over his entire body.  It takes on a different look and kind of flattens and darkens after a coupld of days. It seems to sort of blend a little on some of the areas.  The doctor diagnosed it as sore throat with possibly echo virus or mononucleosis.  We later took him in and a different doctor thought it looked liked measles even though his shots are up to date. Do you have any suggestions or should we see someone at a children's hospital to diagose him? THank you.

by Alan Rockoff, MD, Sep 12, 1999 12:00AM
Monya:



The rash you describe certainly sounds viral, a diagnosis which would "fit" with your son's fever, other symptoms, and normal blood count.  Measles is, of course, a virus too, though it has a particular pattern which many modern physicians are poor at recognizing because the condition is so rare nowadays.  The color change and "blending" you describe also fit with a virus.  8 days is by no means out of line for this kind of rash.  (I assume he's not taking penicillin or some toehr drug which could cause an allergy.)



Which virus it is doesn't matter much.  Viruses go away without much help.



My advice is this: If your son is still "sick"  (high fever, etc.), perhaps you should visit the Children's Hospital for another opinion.  If not, wau a few more days.  I bet the rash just disappears leaving a little superficial peeling for a while and not much else.



Good luck.  Who says being a parent is easy!



Dr. R
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