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dermdoc19
dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 4069
Experience:  30 years practice in general and cosmetic dermatology
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I have a 15 year old son who has broke out in a rash which

Customer Question

Hello, my name is ***** ***** I have a 15 year old son who has broke out in a rash which includes around his eyes and they have became red and puffy. This all began in August of 2015 and after he came home from a summer camp program held in West Moberly, BC. The lake had been shut down for 3 days by Northern Health because of high bacteria counts, but later opened up. Jacob (my son) was also stung by a bee on the nose while there, but to our knowledge, is not allergic to bee stings.
Jacob was in his fathers care and was taken to a hospital in Calgary and was given steroids and a cortisone cream. The steroids were to be taken as 12 per day for the 1st week, 6 per day for the 2nd week, and 3 per day the 3rd week.
When Jacob was back in my care in Fort St. John, BC. the rash came back but even worse. I took Jacob to ER as we did not have a family doctor and Dr. Everett Versteeg ordered a Hematology profile with IGE level and SPEP (delayed hypersensitivity). (October 18, 2015). He did not want to prescribe steroids again. I asked if this could possibly be a parasite that Jacob may have picked up from the lake and I was advised to have him checked for Lyme Disease. More blood tests were order October 22nd for Hermatology profile, Ferrin, ALT, Creatine Kinase (CK), Urinalysis - macroscopic. Additional tests were ast+alt, idh, aldolase, anti nuclear antibody panel, rheumatoid factor. We were told this may be an auto-inflammatory condition (Dermatomyositis). We are waiting to see a rheumatoid specialist, but as of yet, no appointment has been set. Jacob has been on 3 rounds of steroids and each time he finishes, the rash comes back and is mainly located on his back, around his eyes which are puffy, red and itchy and on his stomach. We were told that this skin condition could be the body's reaction to this rheumatoid problem. He did show signs of swelling around the knuckles and complained of pain around his ankles and knees. The steroids are not helping, we need another course of action.
Thanks Debbie
Submitted: 1 year ago.
Category: Dermatology
Expert:  Dr. Pravin replied 1 year ago.

Hello

Welcome and Thank you for your query posted.

My name is***** and being a Skin, Hair and Nail specialist I would be able to provide you with an appropriate solution to your concern.

Please note that my Goal is to provide you with an Excellent Service .

Before I answer your question I would like to get some more information:

Could you send me a photo of the condition at your convenience?

You can upload the photo on www.photobucket.com and send me the link

Other method of uploading photo or a file is:

1.Click the paperclip icon

2.Click the Browse icon

3.Click the Browse button

4.Select your file and click Open

5.Click OK

6.Click Insert

7.Click Save Changes on this page

Please note that the answer provided is for information purpose only and does not substitute a Doctor - Patient Consultation in Clinic

Customer: replied 1 year ago.
files attached of jake's eyes
Customer: replied 1 year ago.
Did you receive the pics...I only have ones of his eye on my phone right now.
Expert:  Dr. Pravin replied 1 year ago.

Thank you very much for the photos sent.

Does he have the rash on the back of his knee or front of the elbow ?

Has he always had a dry skin since childhood ?

Do you have the images of the tests reports mentioned above that you can forward me here ?

Customer: replied 1 year ago.
Hello...no the rash isn't on the front of his elbow or on the back of his knee. the lab test results came back fine when we followed up with the doctor but his white cells we're higher than normal..but I will see if I can get a copy of those results .I have attached another picture of the rash on his stomach and back.
Customer: replied 1 year ago.
Good afternoon. I am attaching the lab results as per your request.
Jacob has never had a dry skin issue. He has had chicken pox at a very young age (when he was only a year old).
I also attached photos of the rash on his stomach and back (begins at his tailbone and spreads upward).
I asked the physician we seen if this could be lyme disease or a possible parasite??
I appreciate your help in this matter.
Customer: replied 1 year ago.
Hello,,,have you had an opportunity to review the lab results?
Expert:  Dr. Pravin replied 1 year ago.

This is not Lyme or Parasite related

Expert:  Dr. Pravin replied 1 year ago.

The rash caused by this condition is related to Atopic dermatitis which has aggravated on the trunk area due to a secondary viral infection

Expert:  Dr. Pravin replied 1 year ago.

The blood reports are very evident of this condition.

Customer: replied 1 year ago.
what does this mean? What can we do for him or what to give him....this isn't telling me much.
Customer: replied 1 year ago.
Awaiting your answers...what do we need to do here for him
Expert:  Dr. Pravin replied 1 year ago.

He should be applying , Tacrolimus ointment which is a non steroidal option on the area twice a day for around 20 days.

This should be done proactively on a daily basis till the irritation goes away .

This is only for around the eye area.

The rest of the body he should use a barrier repairing cream called Aveeno Skin relief cream or lotion on the body to help heal the area.

He does not need any anti viral for this.

Because atopic dermatitis can be long lasting, it is important to learn how to take care of the skin. Treatment and good skin care can alleviate much of the discomfort. Liberal use of Moisturisers can help.

Does he get fever or asthma issues frequently ?

Customer: replied 1 year ago.
no he doesn't seem to have a fever and has never had issues with asthma. can this tracrolimus ointment be bought over the counte..I ended up taking him to the ER last night because he could barely open his eye and the itchiness was driving him nuts...the doctor there said everything pointed or screamed out allergies.
Expert:  Dr. Pravin replied 1 year ago.

Yes , Atopic Dermatitis is associated with allergies ,

Hope they gave him some prescription creams and syrups like Hydroxizine.

He will get the tacrolimus ointment as a prescription from the Dermatologist or Doctor.

You can start him on Syrup Claritine once daily at night.

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