livedo racemosa

My ten year old son was biten by an insect two months ago. The bite became swollen and red. The next day the lesion was not swollen anymore but he had multiple red raised spots on his arms and legs. My doctor told me not to be worried, cause the rash was probably an allergic reaction. A month later we went on vacation and I was still worried because the rash wasn't gone yet. I consulted a doctor again (during vacation) and he prescribed Prednisolone, because he thought it was an allergy also. Within a few days the red-blue raised spots disappeared and I was reliefed. After I stopped given him the Prednisolone the rash came back and this time the red blue raised spots were itching and on his arms, legs and buttock. He has no pain or other symptoms besides the rash I described. When he's sleeping or not moving a lot, the rash seems to fade away a bit. When he's moving a lot the rash tends to get worse. Last week (two months after the insect bite) I took him to a dermatologist and he called the rash LIVEDO RACEMOSA and performed a biopsy. I have an appointment scheduled to discuss the result of the biopsy in about two weeks. Could this be an allergic vasculitis, caused by the insect bite? How should his treatment be?  And what are the prognoses? I hope you can give me some clues about what he might have.
Thanks a lot!!

Greetings Sandra

[Alan Rockoff, MD]

Sandra:

A livedoid, or network-like rash, usually has much less significance in a child than in an adult.  Your dermatologist correctly wants to rule out vasculitis, though even that condition is not necessarily very serious in a kid.  On the other hand, the biopsy may (and probably will) rule out vasculitis, leaving you with a cirious but not very significant situation, which may well require no treatment at all.  If I were you, I would hold off worrying a bit, until the biopsy is back.  This should take only a few days.

Who said parenting wasn't a challenge?

Good luck.

Dr. Rockoff