Have Pediatric Questions? Ask a Pediatrician.
I'll do my best to answer your question. If you're available for chat, let's get started. If not, I can switch to an e-mail format.
I'd like to know how long it's been there and if you could attach a picture.
5 days and give me a second
it resembles heat rash but is only in a 2 x 3 spot
Ok. I see that. Thanks for the picture.
I also noticed a hive on the back of her arm.
nothing has changed in her diet
Is that a photo of her back with the shirt pulled up towards the neck? I'm trying to get my bearings.
yes. white spot on right under shirt is her bra
Ok. And the area you're talking about is just to the right of center, correct?
Where it looks a bit inflammed?
Does that area of inflammation cross from one side of the spine to the other or does it stay to one side? Hard to tell from the picture.
It stays just on the right side. She is also showing me where she has it on the top of her belly but it isnt inflamed
Is the area on the belly towards the right side as well (towards the flank?) like it might be in the same line as the spot on the back if you drew a line from one area to the other?
I think I understand. yes it starts at the same height on her belly but goes down toward belly button
OK. There are a couple possibilities here but I wonder if she might have shingles (zoster) in it's early stages.
Shingles typically begins as a sensation of itching and pain prior to the onset of any skin lesions.
Then there begins to be redness/inflammation and then the development of red, fluid filled, skin spots that look a bit angry.
It tends to itch but if you scratch it it hurts. Sometimes it can be quite painful.
I'm going to post a photo.
she never had chicken poxs
It would make it more likely as a diagnosis if she had, but if she's received the vaccination we do sometimes still see shingles. Also, it's possible she could have had chicken pox when she was very young, had only 1 or 2 pox, and you wouldn't necessarily know it.
So, not having had chicken pox doesn't exclude the diagnosis of shingles.
The big key to it is that the rash needs to follow a "dermatome" which is a nerve distribution that is pretty specific.
ok. so I just should just keep an eye on it?
It very rarely crosses the midline of the body, so if she has it on the right AND left sides of her belly button or spine it's likely not shingles.
Generally the course if self-limited and the lesions erupt within about a week of the onset of the initial sensation, then dry up over the course of another week or so.
If she has shingles and someone who has never had chicken pox touches the rash they could get chicken pox, so you'll want to keep the area covered with clothing.
Sometimes patients can get a little flu-like illness with the eruption
Let me list another couple possibilities for you. Rashes can be tough to diagnose in this forum but I do my best.
It's possible that it's some kind of contact reaction, however, those tend to itch rather than hurt.
If she's not had any new creams, lotions, soaps, detergents, sunscreens, and the like, it's likely not the case.
Sometimes we will see rashes like this in kids who have recently been to the beach. Is that the case for her?
Not in Chicago.
:o) Poor girl!
I havent changed any detergent or soaps
Ok, so that excludes issues with sand fleas, etc.
I'm going with the shingles. If you start to see little blisters forming over the next few days you've got your culprit.
Unfortunately, shingles can recur throughout one's life.
again, Thank You
Ive given her benadryl
If that turns out to be it, encourage her to tell you right away if she experiences it again as if you can get her to a physician within 48 hours an antiviral medication called acyclovir can be very helpful in lessening the course. You're probably too late for that at this point.
Benadryl is fine for itching and will help her sleep. This can get quite painful sometimes.
Motrin and tylenol for the pain as needed.
If it becomes very painful she might need something stronger.
She can go to school if she is able so long as the area is covered with clothing.
If things are getting progressively worse but you're not seeing blister formation then I could be totally off base, so be sure to have her examined if that happens.
I hope she recovers quickly.