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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Rashes. Is it fungal infection? On nystatin. Is it chicken pox?

Hello. My 9y/o son has a rash that started about a week ago.He is up-to-date on all of his vaccines and I have seen 3 different doctors/nurses at an urgent care clinic near me and no one can identify the cause.He does not feel ill or have any other symptoms. It started off like a small red ring that resembled ring worm on his left thigh, so I immediately bought an anti-fungal cream. The very next morning he had more red-itchy blotches, but they did not have a ring-like appearance and they were spread all over his body (most affected areas were on the legs and the arms). When I first took him to the urgent care clinic, they said it was contact dermatitis and recommended claritin/ benedryl , calamine lotion, and hydrocortizone cream. This did not help and the rash continued to spread, itch more, and some began to have tiny fluid filled pustules. The second time I brought him into the urgent care, they said it appeared to be a fungal infection and prescribed him nystatin ointment and azythromyacin.The ointment did not seem to help and seem to cause some of the pustules to break open - releasing fluid. Still having no idea what the cause is, I reached out to friends and family and they recommended oatmeal baths, witch hazel, and other things. I tried the oatmeal bath first and it still did not relieve his symptoms. I tried the witch hazel and he said that it felt AMAZING and seemed to relieve his itching for a longer period of time. I returned to the urgent care clinic a 3rd time and this time they prescribed prednisolone and told me to continue the witch hazel since it makes him comfortable but they still could not tell me the cause of this rash. He has been on the prednisolone for 4 days now, he still feels itchy, his rash seems to be clearing but I noticed that he has a few bumps on the outer edge of his ears now. He has large flat red/pink patches on his upper thighs and scabs over most of his body from where the pustules were scratched and leaked fluid. I have been told that this could be a type of chicken pox. Is this possible? I can send you pictures if this would help identify the cause.
Thu, 7 Feb 2013
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Pediatrician 's  Response
Hi,
Thank you for your query,
With your description of the clinical condition it is looking like a papular urticaria or a contact dermatitis.
It is not chickenpox as there is no fever and in chickenpox the lesions will be more on trunk and less on limbs and they are pleomorphic.
Send clinical photographs are consult a dermatologist for the diagnosis and appropriate treatment.
Hope I have answered your query.
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