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What causes weeping red skin behind ears?

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Posted on Mon, 21 Jul 2014
Question: My eight year old daughter has been battling a rash behind her ears for nearly two months. It started first on one ear, completely broke out and just as that was healing (still not completely healed but so much better) the other ear got the same rash. Behind the ear and into her hairline it get's dry, flaky, itchy and then oozes yellow and bleeds from picking/itching. Her earlobe skin hardened (the one that is healing is soft again but it's been almost two months). I thought it was possibly a food allergy but haven't been able to figure anything out there. The rash does go down her neck but I hasn't it been too long for it to be rubella, measles? She hasn't had a fever or any other spots on her but near her ears. I would like to know if there is something I'm missing that I should bring her in for. We have high deductible insurance so I've been keeping it clean and putting different creams to see if it would help but nothing has so far. Does she possibly have something that will only get better with antibiotics?
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Answered by Dr. Sumanth Amperayani (1 hour later)
Brief Answer:
Could be an eczema - No antibiotics

Detailed Answer:
Hi...Thank you for consulting in Health Care magic.

Coming to your query -
Regarding antibiotics I don't see any need for using antibiotics as bacterial infections wont go on like this chronically.

By what you quote and after seeing the photograph of the ear which has a weeping red skin, I feel your daughter might be having an eczema which is a sort of allergy but definitely not food allergy. Usually eczema is the one that starts like this (especially at flexural surfaces) and goes on for several weeks in a waxing and waning course. The other possibility is a fungal infection which occurs at the flexural regions like this. It might respond to antifungal creams use topically.

I have few questions for you -
1. Does anybody in the family have any sort of allergy or atopy or wheezing or nasal allergy etc.?
2. Does anybody have psoriasis in the family?
3. Did your 8 year old have such similar rashes in front of her elbow joints/ back of her knee and neck and other flexural surfaces when she was less than 1 year old?
4. What are the creams that you have been using for her for the past 8 weeks?

I suggest you get back to me with the answers to the above questions so that I would be in a better position to help.

Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.
Dr. Sumanth MBBS., DCH., DNB (Paed).,

Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Sumanth Amperayani (31 minutes later)
1. Yes her dad and I both have some nasal/seasonal allergies.
2. No psoriasis.
3. I don't believe she ever had any rashes as a baby, her three siblings did have what doctors called eczema when they were babies (some worse than others) so it does run in the family.
4. I have tried bacitracin, coconut oil mixed with lavender essential oil, lotrimin AF (which says it's for athlete's foot, jock itch and ringworm-- clotrimazole 1% -- is there something that might be more effective)? As of recently I've just been keeping it clean and using Renew Lotion from Melaleuca (it has Melaleuca Oil in it) and it's made the skin a lot softer and soothed some of the itching but hasn't healed anything. I did try oral Zyrtec wondering if it was an allergy (for two days) and she didn't like how it made her feel and it didn't seem to help so I discontinued that.
doctor
Answered by Dr. Sumanth Amperayani (33 minutes later)
Brief Answer:
Suggestions on management

Detailed Answer:
Hi....Thank you for your trust in me.

I feel it is definitely by the history and also by the strong family history. Once it starts it might go on for weeks to months. The good news is that the other ear has already started healing.

I suggest the following -

1. Apply topical emollients like aloe vera cream.
2. Use of mild steroid cream like - Hydro cortisone cream is very helpful, but I suggest you use it in tapering schedule.
3. In such long standing cases - oral Monteleukast will be helpful. I would start her on 5mg dose every day at 6PM for 8 weeks.
4. Oral Cetrizine (at the dose of 0.25mg/kg/dose daily once at night) is helpful to reduce the itching. But since she doesn't tolerate zyretc (which contains cetrizine), you should discuss whether or not the current dose is causing it. If not, other antihistamines may be used.

Discuss about these options with her treating doctor.

I wish your kid a speedy recovery. If you are happy with my suggestions, please rate my suggestions. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below.
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8343 Questions

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What causes weeping red skin behind ears?

Brief Answer: Could be an eczema - No antibiotics Detailed Answer: Hi...Thank you for consulting in Health Care magic. Coming to your query - Regarding antibiotics I don't see any need for using antibiotics as bacterial infections wont go on like this chronically. By what you quote and after seeing the photograph of the ear which has a weeping red skin, I feel your daughter might be having an eczema which is a sort of allergy but definitely not food allergy. Usually eczema is the one that starts like this (especially at flexural surfaces) and goes on for several weeks in a waxing and waning course. The other possibility is a fungal infection which occurs at the flexural regions like this. It might respond to antifungal creams use topically. I have few questions for you - 1. Does anybody in the family have any sort of allergy or atopy or wheezing or nasal allergy etc.? 2. Does anybody have psoriasis in the family? 3. Did your 8 year old have such similar rashes in front of her elbow joints/ back of her knee and neck and other flexural surfaces when she was less than 1 year old? 4. What are the creams that you have been using for her for the past 8 weeks? I suggest you get back to me with the answers to the above questions so that I would be in a better position to help. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. Dr. Sumanth MBBS., DCH., DNB (Paed).,