Another Rash Mystery (cross-post in Feeding Baby); pix attached. Help!!

[eb1]

My 15-month DS has this rash on both his arms, around his elbow (the back of his upper arm and below the elbow). Pix below. This rash originated several MONTHS ago, as a small patch on one arm and on the back of his calf. I saw the ped. twice at the time, and he dismissed the possibility it was eczema or a food-allery rash, saying it is a mild contact rash, from, presumably something in DS's environment. The ped. didn't seem to think we needed to worry about it or track down the source, even though DS previously had similar patches (usually on arms or legs) that hung around for a couple months before finally clearing up.

Ok, now in the past week, the rash has grown and gotten much redder, and is on both arms. This is the worst I've ever seen it. The related patch that was on his calf has, however, started to clear up. It does not seem to itch or bother DS. It's a little rough (not terribly), a little raised, patchy, and seems to become more red/irritated by the end of the day, but does not ever totally disappear.

Regarding the ped's theory that this is an environmental irritant: We do not use perfumed or fragranced detergents or soaps (never have), and the rash is mostly on parts of DS's body that are not in contact with clothes anyway. I've been using a hypoallergenic Aveeno Baby Cream for Eczema (forget the real name) on the spots after bathing DS, and the cream doesn't seem to help or hurt. We don't have pets, plants, or anything in the house that seems a red flag otherwise, and we mostly hang out at home. I can't think of anything that these parts of DS's arms come in contact with that would cause this.

This never flares up or gets worse after DS eats a particular food, and the only food I am starting to suspect is dairy/milk because it's a continual part of DS's diet. I've read the Dr. Sears and kellymom info on milk and food allergies, but none of that clicked with for me with this rash; plus DS had a few patches of this before he ever began to drink cow's milk. (I did and do BF DS, and I eliminated dairy from my diet briefly when he was an infant and had patches of rash on his face, but my elimination of dairy didn't seem to affect DS's rash.) Otherwise, he doesn't have diarrhea, stomach problems, ear infections, colds, diaper rashes, etc. that could signal a milk allergy.

Does this look like ANYTHING anyone has seen before?? Does it sound like a milk allergy? Eczema? I'm super frustrated here, and no one (including DS) around me seems to think much of this rash. I'm taking DS back to the ped in another week or two, and if he dismisses the rash again, I might just switch doctors.

Thanks for reading this, and thanks for any suggestions/theories.

[schums]

Just a long shot here, but has the weather changed signifcantly in your area over the last week? It has gotten stinking hot and humid here in Michigan (90+ degrees, 90%+ humidity everyday) for the last week. Could that be what's causing the latest (and greatest) flareup in this unnamed rash?

We never had problems with food allergies, so I'm not going to be much help there, although I've heard milk allergies usually are more encompassing than rashes. And the only rash we had on a regular basis was heat rash, which looked more like pin pricks than what your son has.

Maybe its time to ask for a referral to an allergist and get it settled once and for all.

HTH,

Sarah
Alex 3/2002
Catherine 8/2003

[eb1]

Thanks for the response. We live in Florida so it's been really hot for a while now, no big changes in the past week. I've been keeping DS as cool as I can (and indoors!) because he's very quick to develop heat rashes as well, which clear up quickly. Perhaps there is a heat component to this, however. I'll watch that.

I think you're right about asking for a referral. My ped. was just so casual about it all, like it was nothing, that I'm sure HE won't suggest a referral.

[Sarah1]

It looks like eczema to me. Audrey had eczema well into her first year and a half or so. There weren't really major triggers. We used hydrocortisone (1/2%) and Elidel on it (which worked great, but there have been some disturbing studies about Elidel as of late, so I'd be cautious of going that route). Eventually she just grew out of it. It definitely got worse in the heat when she was sweating, etc. Try not to stress too much about it--I'm sure your DS will grow out of it and it doesn't sound like it's causing him any discomfort.

[amp]

It looks like eczema to me too. My son has it and that would be my first, albeit uneducated guess, based on the pics.

Try using some Aquaphor or Eucerin cream on it, both of which our ped recommends when we are trying not to use so much Elidel. And I don't know how often you bathe, but try not to do it every single day and try to keep the bath lukewarm and not too hot. And moisturize, moisturize, moisturize. All of these might help, whether it's eczema or not.

good luck!

[marchmommy]

I posted on my DS' mystery rash a few days ago, and I have to say, this looks like his rash! It is so frustrating that the Dr's don't think it is a big deal and so don't seem to care too much, and I have gotten completely different responses from different Drs. My son's started on his left arm, and now is on his legs too. I am putting this triamincolone (spelling?) cream on it and the Drs said to put moisturizer on as well. I have a feeling it's an allergy, too, and don't know to what--perhaps it is heat, after all, but why now and not last summer? BTw, how did you get such great photos? I tried with my digital camera, which I thought was a pretty decent one, and it didn't come out clearly....

[nd93]

That is EXACTLY what my daughter's arms look like! She is 3, and has had bouts of excema since about 9 months. It flares up worse in the summer, especially if she's been outside and gotten hot and sweaty. I usually am able to control it with moisturizer, but for flare ups I use trimicinolone. I just put some tri on her this morning b/c the lotion didn't seem to be helping. I'm also not giving her yogurt this week - I've heard/read that dairy can flare up excema. She does not drink milk/eat much dairy except for yogurt which she eats tons of. So I'm going to try that and see. Also, this time her trunk has a mild rashy look to it. I wouldn't even go so far as to say it's a rash as it just looks kinda pinkish, like a mild sunburn (but I know it's not that. I'm in Seattle and all we've had is rain lately!)

Let us know if you find anything out or if any treatments work! I'll let you know how a few days of the tri does.

Good luck!

[eb1]

Thanks to everyone for the very helpful information. I am going to pay close attention to the heat component, because I do think it was better during the winter, and flared up last summer too (but not to this extent).

We wound up making a trip today to the ped., who finally said it looks like eczema. He prescribed Elocon and said to use it sparingly. DS doesn't show signs of being bothered by it, but the rash is getting inflamed and I can't imagine that it's not somewhat irritating.

Does anyone know anything about Elocon?

To the PPs, please do let me know how the trimicinolone works.

Oh, and I got the pictures using our Nikon D70, a digital SLR. It was an uncharacteristic splurge but I was frustrated with my previous digital camera and wanted to have some great shots of DS growing up. I love it and am so glad we spent the money. Now if I could just learn some of the settings beside "auto"!