This is in retrospect a fungal infection missed, thanks to kenacomb! Steroids appied on a fungal patch change it so much that it becomes virtually unrecognizable (Tinea incognitio). This is a zoonotic fungus and thus the florid presentation. I am kicking my self to have missed out this spotter!
Thank you all very much for your time & effort, it is greatly appreciated!
We have since seen another paediatric dermatologist and had scrapings done - its a confirmed fungal infection. As it was left for 22 days with no treatment (while we did the viral rash dance) the kids became extremely florid with the rash. They are both on Risovin (antibiotic that treats fungal infections) and will hopefully be on the rd to recovery. The cause was our new little kitten we bought from the vet.
Hello,
Since both your daughters are having this rash at the same time, hence it can be due to a viral rash or pityriasis rosea as her doctor has suggested. If it is a viral rash then it is usually contagious and can spread. Also the diagnosis of pityriasis rosea needs to be confirmed because it is a non contagious rash.
I suggest you to consult a dermatologist and get the rash examined from him.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.
These are typical EM minor traget lesions, possibly following chicken pox, in both kids. These would settle down in a week or two. Quite rare to occur as a cluster, but then could well be due to immune factors.
http://books.google.com/books?id=Woq0HVYwr4kC&pg=PA342&lpg=PA342&dq=kenacomb+and+pityriasis+rosea&source=bl&ots=yJJ4JyAZfX&sig=kgyGq4tN5yp9kXJ6MOhRYI8Zlzk&hl=en&ei=6kklTpzINIrd0QHs7KjRCg&sa=X&oi=book_result&ct=result&resnum=1&ved=0CB8Q6AEwAA#v=onepage&q=kenacomb%20and%20pityriasis%20rosea&f=false
I just wanted to send you this link because it lists quite a few skin diseases that you may want to take a look at. I did some research for you :) and I do think that your child has pityriasis rosea as opposed to ringworm for the following reasons
1. In the picture your daughter's inner ring is more prominent than in ringworn.
2. They both had what you call herald patches or the chicken pox like lesions you noticed which is textbook pityriasis.
3. They are not responding to kenabomb. This is because Pityirasis is most likely caused by a virus, not a fungus. However oral antihistamines (Benadryl) can help with itching.
4. This can last up to 14 weeks and can be reoccuring (although uncommon) similar to a cold sore caused by the herpes virus. (Pityriasis Rosea is thought to be caused by a herpes virus).
5. This condition is very common in children,
It is curious that your daughters both developed this at the same time. although not uncommon. Doctor's don't totally understand how it can occur in more than one family member at a time, but not be contagious from person to person. Seems to contradict, I understand, but some medical mysteries simply need more research. All I can guess is that similar to cold sores that can run in families...your daughters are both carriers of this virus. A skin scraping test can be done to 100% diagnose your daughters with the correct thing. However PR is not harmful and does not scar if you can keep them from itching. I really hope this problem resolves itself and your daughters are happy and healthy again soon! I hope this helps!