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Child started with a rash on arm and spreading to neck and chin. Suggest?

Answered by
Dr.
Dr. Sanjay Kumar Kanodia

Dermatologist

Practicing since :2002

Answered : 4165 Questions

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Posted on Tue, 18 Jun 2013 in Skin Hair and Nails
Question: My son started with a rash on his left arm under his bicep. It started red and minimal. Now it has spread to his neck amd chin and has a couple black spots. Started Saturday.
doctor
Answered by Dr. Sanjay Kumar Kanodia 1 hour later
Hello,

Welcome and thanks for posting your query to XXXXXXX

Myself Dr S K Kanodia and will try to provide you the best of information regarding your query.

As per your query your son has rash from last 4 days started on left arm under the biceps and now spreading to neck and chin.

In your short history you have not mentioned following:
1. Age of your son.
2. Does the rash appeared suddenly in few hours or gradually in a day or two.
2. Is there any history of fever or any systemic symptom like body ache or fatigue is present along with it.
3. Is there any history of contact with some new thing on weekend.
4. Is there any itching over the affected area, or is your son tries to scratch the area.

Now there can be multiple of of the possibilities related to your son's problem. If it is a map like rash then it can be related to simple fungal infection.

If there is presence of fever or any other systemic symptom like body-ache, then it can be related to a viral infection known as viral rash.

If the rash appeared suddenly with some itching or burning then it can be related to allergy with contact of some chemical agent.

For the management part:
1. Do cold sponging of the area for 2-3 times.
2. Apply over the counter calamine lotion very thinly for two times.
3. If there is any itching present then can give antihistamine such as "cetrizine" by mouth two times according to the dose under medical supervision.
4. Keep the area dry and avoid sweating around the area.
5. Ask your son not to touch or scratch any area of the rash.

I doubt about the medial history of arthritis and the medications (tramadol) with gender written as female in your query. Is it somehow related to your son.

You can also upload a picture related to this so that we can advise you better.
For that you have a feature to upload images by yourself at the right side of the query page, please utilize that so that I can answer your queries for the same. Or else, you can send as an attachment to YYYY@YYYY with the subject as "Attn: Dr. Sanjay Kumar Kanodia)

You keep a through watch on this rash. Either the rash will disappear in 2-3 days. If the rash is progressing in next 2 days or if there is any symptom of fever or related thing then it would be better to consult a dermatologist to diagnose the best possible cause.

Hope these informations will help you. If you have any further query I will be happy to help.

Regards.
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sanjay Kumar Kanodia 57 minutes later
My son is 7. The rash started suddenly then progressed to a worse rash over the few days. He has been a little lethargic but no sign of a fever or body aches. He did wear a shirt that was rented from a tuxedo shop. But no one else had that problem. It is very itchy to him and I have put Cortisone cream on the infected area to reduce itching. My highest concern is the sudden black spots which you can see in the photo. On his face & neck.
doctor
Answered by Dr. Sanjay Kumar Kanodia 1 hour later
Hello,

Welcome again to the forum Madam.

Thanks a lot for your prompt detailed reply and uploading a close picture.

I am really empathetic to your son’s skin problem. Now we can make the closest possibility of "allergic dermatitis" of the condition. It can be due to contact with some chemicals which acts as allergen or the offending factor or might be due to bite of the insect aggravated more by sun light, sweating and due to scratching.

It appears suddenly and itching and redness are the most common part in this condition which sometimes makes the condition worse.

As you are applying cortisone which is a mild steroid would not be suffice to prevent the symptoms of redness and itching. I would prefer to apply “Fluticasone” cream to apply for two times and tablet “cetrizine” (if he is not going to school as it causes bit sedation)or “loratadine” (non sedating anti-itching medicine) half tablet 3 times a day by mouth under medical guidance.

The black marks are the “scabs” or medically we call it as “crust” which appear at the site of healing. You can see that these sites are accessible to your son’s scratching. Your son must have scratched at these sites and then these minor scratch points are forming scabs which are normal healing phenomenon. So you should not be worried about the same.

Most specifically let your child should not scratch it, trim his nails, explain the simple condition to your son for avoidance of scratching. Follow the policy of “No sun exposure and no exposure to external environment”, avoid sweating and let him wear cotton clothes. Rests of the suggestions are as before in the previous Email.

Again I request you to keep a close watch on this rash. By doing above enumerated measures in this Email and the previous one, the rash will probably reduce in 2-3 days and disappear in 5-7 days.

If the rash is progressing in next 48 hours or if there is any symptom of fever or related thing or any sign of infection such as appearance of pus filled area then it would be better to consult a dermatologist to diagnose the best possible cause.

Hope these informations will help you. If you have any further query I will be happy to help.

"With good health wishes"

Regards.
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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