rash on child's stomach and back only

[sobo]

My child (19 mo. girl) has gotten a rash ONLY on her stomach and back (NO WHERE ELSE) three times in the last two months. We have not traveled out of the US. The first outbreak was diagnosed as chicken pox, but after the last two rash outbreak, we and the doctors are wondering if she had the chicken pox at all (with it being just the first outbreak of the rash). We have seen our pediatrician, a dermatologist, etc. They both originally suspected some type of insect bite. We then had our house (brand new house, less than 1 year) checked by 3 professional exterminators. They did an extremely thourough job and none found an indication of insects (biting mites, fleas, spiders, bed bugs, etc.). We have had a beagle dog since she was born and we had her checked out by the vet as well as the exterminators (nothing suspect was found on/in the dog). On return to the doctors, blood work was done that showed slightly high lympocytes and was otherwise "normal". At this point, they no longer suspected insect bites since it was only on her stomach at back. The blood test also did not indicate an allergy and does not appear to be a allergy-appearing rash according to several doctors. The doctor believed that wasn't abnormally high and though could indicate a virus she did not believe this was a viral rash (based on the duration and frequency of this). We have since replaced her mattress just in case. It did not work, the rash came back. We have never change her bath soap, lotion, detergent, etc. (or ours for that matter). The rash does not seem to itch (she doesn't show signs of trying to itch it) and doesn't present with fever. She possibly seems slightly fussy but nothing definite. She is not in daycare. No other children that she comes in contact with have presented. Even after keeping her completely in, the rash presents. She has had no signs of cold or viral respirtory illness since long before the first outbreak. Please help me figure out what is plaguing my 19 month old girl. We are frustrated and frightened. Thank you.

[Alan Rockoff, MD]

I'm afraid I can't make any definitive diagnosis.  I will say that this does not sound like anything that will have a serious impact on your daughter's health.  There are a lot of funny rashes that are hard to pin down but that don;t turn out to be of much consequence.

My advice is to re-consult the dermatologist and inquire about the possible usefulness of a skin biopsy (a very minor procedure, even in an infant), as well as a possible diagnosis of pitryiasis lichenoides chronica, an uncommon rash that can look a bit like chickenpox at some point.  Not serious, hard to treat, but it ultimately goes away by itself.  Of course, that's no more than an educated guess.

Best.

Dr. Rockoff

[sobo]

I forgot to say. There are probably 50-60 total spots this time. From a couple mm in diameter, most are pea size and a couple a little larger than that. They are red and raised. They look like the chicken pox or a bug bite, etc. She has had the measles already (around 13 months). She has had all the vaccinations also and is current on those. Some of the spots have small white heads.

[bilateral]

A related discussion, my sister has the same type of rash that the 19 month old child has. was started.