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Nurse Susan
Nurse Susan, Nurse (RN)
Category: Health
Satisfied Customers: 1084
Experience:  RN, BSN, MSN-ED, Nurse Educator whose passion is helping people understand their health and wellness
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My daughter has a a painful circular rash, each 2-3 cms in

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My daughter has a a painful circular rash, each 2-3 cms in diameter. The circular edge blisters within a few days and the circle of skin is typically shed. She has the rash on one leg and both arms, about 10 circles in total (some of them overlap). Blisters form within about 3 - 4 days of fist symptoms which is slightly discoloured circle, a bit like a light bruise. An thoughts?
Submitted: 1 year ago.
Category: Health
Expert:  Nurse Susan replied 1 year ago.
Hello JACustomer,

I am so sorry to read of your daughters situation. It would help if I could see a picture of this rash that she has. Is there any way that you can upload one? If not, that is fine, but my resultant guess will not be as informed. Has she been on any new medications or exposed to anything new recently? Does she have any other symptoms besides the pain...any fevers?

Thanks for the additional information,
Sincerely,
Susan
Customer: replied 1 year ago.

Hi


Here is a link to some pictures


 


https://skydrive.live.com/?cid=abac0074ff16182b&id=ABAC0074FF16182B!315


 


Pictures show ...


day 1 - mild burn like area


day 6 - distinctive ring, blisters now burst,


dayXXXXXof skin lost exposing new layer underneath


 


With respect to medication, no, she hasn't been taking any medication and hasn't changed deodorants etc (which she has now stopped using). First rash appeared on exposed part of arm (i.e. no clothing contact), subsequent rashes have appeared in clothed areas as well.


No fever, just the pain, pain seems to be local to the areas with rashes (e.g. lower arm, upper arm) atc and are more acute when they are being moved.


Thanks


Neil

Expert:  Nurse Susan replied 1 year ago.
Hello JACustomer/ Neil,

I tried to access the site you gave me, but Skydrive wanted a username and logon ID from me. Can you give me a temporary ID and password XXXXX I can get onto the site? Alternatively, if you click on the paperclip icon, I believe you can attach pictures to this chat thread. If that does not work, you can email the images toXXX@XXXXXX.XXX and ask them to be placed on this chat thread (please give them the link to this question) It may take a while for this last one to get to me though. If none of these work I will answer just based on written descriptions.

Thanks allot,
Sincerely,
Susan
Customer: replied 1 year ago.

Pics attached.


 


Sorry, didn't realise they could be attached!


 


Neil


 


 


 


 


 


day1


 


day6


 


 


day8

Expert:  Nurse Susan replied 1 year ago.
Hello JACustomer/ Neil,

Thank you so much for attaching those images, it is true that a picture indeed says a thousand words. That does look to be incredibly painful, and I hope I can be of some help here. Please understand though that online (or offline for that matter) I can not diagnose or state with certainty what anything is, I can only give my best educated guess based on what I see.

Dermatology can be quite a challenge, and it is one reason why health care is as much art as it is science; two practitioners can look at a rash, and much like looking at a painting, come to two different interpretations of what they see. I can certainly understand looking at that why your treating doctor believed it may be erythema multiforme, but there is no history of any new medications or anything that she could be having such a bad allergic type of reaction to. The worst case scenario of this type of reaction is called "XXXXX XXXXX syndrome" (I am NOT saying she has this, not by a long shot...this is for information only; the worst possible outcome) and people can be hospitalized with it and it can indeed be life threatening. Here is more information on this: http://www.mayoclinic.com/health/stevens-johnson-syndrome/DS00940

So I am not and can not discount the possibility that there is some degree of erythema multiforme happening here, and she should be treated for this (as is appropriate) if this is a thought. Yet, when I look at these images, I wonder if I am looking at a bacterial rash called impetigo.

Impetigo is caused by either staph or strep bacteria and can be quite contagious. In children, its generally acquired originally through a cut of some type and spreads as the child scratches or rubs at the sores. There are several different types of impetigo but its hallmark features are the red blister like sores that rupture and form a yellowish crust, which is not only like what you describe, but I think I see some of that yellow crusting in the middle picture on the left side of the lesion. Impetigo is cured with the appropriate antibiotics; it can be treated easily, but untreated it can have some bad complications relating to the infection. More information on Impetigo is available here: http://www.mayoclinic.com/health/impetigo/DS00464

Images of Impetigo are here: http://www.dermnet.com/images/Impetigo

Your daughter has had these for a while, and they seem not to be improving. I think a good suggestion here is a consult with a dermatologist, as they specialize in skin disease and skin disorders. That way, she can get appropriate diagnosis and correct treatment.

I hope I was able to help, and that she feels better soon.

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I am here if you have further questions.

 

Sincerely,

Susan







Nurse Susan, Nurse (RN)
Category: Health
Satisfied Customers: 1084
Experience: RN, BSN, MSN-ED, Nurse Educator whose passion is helping people understand their health and wellness
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