One Year Old Sudden Face and Hands rash

[gydget]

A couple of weeks ago, my doctor began weaning me off hydrocodone that I had been taking for a couple of years for terrible parethesias I get that can land me in the emergency room, and he put me on a drug called Neurontin.  I am still breastfeeding and he knows it I am pretty sure since my GYN doctor was the one who told him she wanted me off the Vicodin.  A couple days after I began taking the new drug, my beautiful baby girl started developing a rash on her face and hands that became so bad in the next few days that I ended up running her in to the office at the last minute.  The day before I brought her in, she had been put on amoxicillin for an earache (which later I read can be attributed to an allergic reaction.  Also at this point I thought she was just having another "flu rash" as she always gets those when she is sick) so the doctors told me she was allergic to the amoxicillin but I repeatedly told them she had been developing the rash at least four days prior to me bringing her in but they would not listen to me.  

They put her on cortisone creams, a new antibiotic and ear drops and she got better but she still has little rashes in the same spots that come and go daily.  I am still on the vicodin and the neurontin, which the doctor told me was alright, while I am waiting for the nuerontin to work.  She has never had a reaction to the pain medication before and my husband swears it must be the nuerontin but I am afraid to tell my doctor about this because of all the stigma around vicodin and I want a real opinion about which drug she could be having a reaction to? Also, if I go off the vicodin without the neurontin working yet, I will be in enormous discomfort.  Please please help!!

[Alan Rockoff, MD]

OK, I'll try.

Your baby's rash is not an allergy to amoxicillin because, as you point out, the rash preceded it.  She is also not allergic to neurontin, because the rash would not have gotten much better while you are still taking it.  (Allergies to drugs in breast milk can in theory occur, but they must be awfully uncommon; I've never seen one.)

By a process of elimination, then, your baby's rash appears to be something other than a drug eruption.  What could it be?  While I obviously cannot say with certainty, the most common itchy rash in infants is eczema.  This would get better with cortisone creams, and would be likely to reappear a little off and on thereafter, just as you say hers does.

Can eczema come all over "out of the blue?"  You bet--happens all the time.  Cause?  None--that is, the sensitivity involved is hereditary, not allergic or environmental.

My advice is therefore the following:

1)  Have you doctor examined by a dermatologist, who can give you a definitive diagnosis.
2)  Continue the neurontin, if your doctor feels it's best for you, without guilt.  In all likelihood, you and your needed treatment are not responsible for her rash (which may well get milder as she gets a bit older.)

Best.

Dr. Rockoff

[Hearya]

My one-year old son also developed a rash on his cheeks during the last week.  He'd had a rash on his face for a couple months, so I finally took him to the pediatrician.  He told me to apply 1% cortizone ointment twice daily, as well as Eucerin lotion as many times a day as I could remember to do so.  After just a couple days, I could already see an improvement.  The rash went away ... but then another one appeared last week - after his birthday party.  I am using the same treatment as before, but it doesn't seem to be working.  I wonder if it could be "Baby Rosacea."  If anyone has a suggestion for OTC treatment, I'd appreciate hearing about it.  I keep hoping it will clear up, so I can have his one-year portraits done soon.

[gydget]

I hope the doc reads this also.  I am adding to this thread to inform you all that my baby was eventually diagnosed with Valley Fever, or disseminated coccidioidomycosis, a deadly infectious fungus that can be breathed in by anyone here in Southern California.  Her main symptoms were the rashes, but the one that clinched it was a horrific lesion that began to grow on her back the week I posted here.  The HMO bounced us around for awhile, but by mid March somone had figured it out and we were admitted to Children's Hospital in Los Angeles.  She had not progressed to the usual meningitis thank God, but there was a suspicious spot on her lung, and she is now being infused daily with ambisone and has had no reactions to it so far.  The doctors say she will most likely be cured but might have to be on oral medication for a year or years, depending on her.  Apparently, there are many children with it near us right now.  The construction in the area stirs the fungus spores up and people then breathe it in.  Here are some links about Valley Fever:

www.valleyfever.com

http://www.csubak.edu/healthcenter/ValleyFever.htm

http://www.casa.arizona.edu/~peter/valleyfever/web/page4.html

Thanks for listening,
gydget