What could this be ----- itchy raised bumps on knees, elbows and bum.

[khalloc]

DS woke up late Friday night with very itchy knees and elbows. He has bumps on both. Smaller than mosquito bits, bu much more circular and raised. Then Saturday at bedtime he started itching his bum and on one butt cheek he had about 8 more of these raised bumps.

He has had hives before when he was much younger, but they looked totally different. Back then they were huge like a red raised map area. We never did find out the cause...probably viral.

He is working on a cold. Just got the flu shot on Tuesday. He has viral-induced asthma. He did have a tick bite a few weeks ago, but we know the tick was attached for under 24 hours and the doc just looked at the bite area this week and thought it looked ok. (no bullseye rash)

These itchy bumps are keeping him up at night scratching.

[DrSally]

I hope it's not molluscum, but given the intense itchiness, maybe post viral hives?

[alexsmommy]

Atypical hand, foot, and mouth caused by CAV-6?

[wendibird22]

Dermatitis herpatiformis? It's the skin manifestation of celiac. Most common areas on elbows, knees, butt, back. Usually symmetrical on both sides of body. Intensely itchy and worst at night. Sometimes the rash is fluid filled. When it heals it sometimes leaves behind purple-ish scars.

[khalloc]

Well I asked our neighbor who is
And Doc and she thinks it's
Eczema. She said its common with asthma?

[trales]

We are dealing with something similar, we have been to the pedi twice, and have a derm appt at 830 tomorrow am. We have tried antibiotics, to which we had an allergic rxn, and steriods which have done nothing.

I don't care what it is at this point, I just want to know and be able to do something and have us all get some sleep.

[ha98ed14]

Dermatitis herpatiformis? It's the skin manifestation of celiac. Most common areas on elbows, knees, butt, back. Usually symmetrical on both sides of body. Intensely itchy and worst at night. Sometimes the rash is fluid filled. When it heals it sometimes leaves behind purple-ish scars.

Your sig makes me think you have some BTDT. That sounds incredibly painful and to be left with scars, ugh.

[carolinamama]

Well I asked our neighbor who is
And Doc and she thinks it's
Eczema. She said its common with asthma?

That was actually my very first thought with the time of year. This is exactly how DS1 presents although his is very mild. We use Cetaphil lotion every night and it helps keep it at bay.

[wendibird22]

We are dealing with something similar, we have been to the pedi twice, and have a derm appt at 830 tomorrow am. We have tried antibiotics, to which we had an allergic rxn, and steriods which have done nothing.

I don't care what it is at this point, I just want to know and be able to do something and have us all get some sleep.

Just in case you or anyone following this thread are interested, dermatitis herpetiformis doesn't respond to steroids like some rashes it's confused with do.

[wendibird22]

Your sig makes me think you have some BTDT. That sounds incredibly painful and to be left with scars, ugh.

Thankfully no BTDT experience with it. But I hang out on a celiac board and have learned a lot about it from others. I did have eczema on my elbows prior to going GF and it did go away after GF and has never returned.

[Melbel]

Your description sounded like eczema to me as well, and it is more common with kids with asthma/allergies.

As for the tick bite, Lyme and other tick born diseases can be transmitted in far less time than 24 hours (although literature often states 24-48 minimum, Dr. Burrascano, a widely acclaimed Lyme specialist states 4 hours: https://sites.google.com/site/drjoneskids/treat-the-bite). Also, the majority of those with Lyme do not develop the classic bullseye rash (not to mention that other tick born diseases such as Bartonella, Rocky Mountain Spotted Fever and a host of other infections do not cause bullseye rashes).

Consider the much higher incidence of Lyme and other tick born diseases as well as the unreliability of the bullseye rash, doctors are more readily ordering prophylactic antibiotics. Here is a recent article on the subject: http://pittsburgh.cbslocal.com/2012/09/25/doctors-change-treatment-recommendations-for-lyme-disease/

Rashes from ticks can manifest in a variety of ways. I personally would err on the side of treating prophylactically for Lyme and co-infections.

ETA: Many with Lyme have numerous manifestations of inflammation and autoimmune illnesses such as gluten intolerance, dairy intolerance, asthma, eczema. Also, please note that steroids are contraindicated for Lyme (or a potential Lyme infection) because they can suppress the immune system.

[khalloc]

Rashes from ticks can manifest in a variety of ways. I personally would err on the side of treating prophylactically for Lyme and co-infections.

ETA: Many with Lyme have numerous manifestations of inflammation and autoimmune illnesses such as gluten intolerance, dairy intolerance, asthma, eczema. Also, please note that steroids are contraindicated for Lyme (or a potential Lyme infection) because they can suppress the immune system.


I feel like this problem on his elbows/knees/bum is probably eczema. He's had dry skin here before, but never this bumpy. I have been putting cream on it and will continue to do so every morning and night to keep it moisturized. But it doesnt seem like this would be Lyme related. He's had asthma issues since he was 9 months old so I dont think his asthma is related to any tick bite. He's only gets symptoms when he is sick with a cold/stuffy nose/runny nose...the rest of the time he fine and doesnt need asthma meds unless he has a cold.

I guess I am just not convinced that the tick could have anything to do with it? Plus his doc did not seem inclined to do anything about the tick bite. I realize she's not a Lyme expert, but I do like and trust her. And without specific symptoms of Lyme I feel silly demanding she treat him for lyme I guess.

[trales]

We just got back from the derm with our rash issues. Since the rash was totally symetric and not on the trunk or face, he thought is was an antigen reaction to some infection she had but was asymptomatic for. We are using a topical steroid and another cream, an antihistamine and antibiotic. If it is not a lot better by wed we get oral steroids.

I am so over this and really just want to sleep.

[Clarity]

Well I asked our neighbor who is
And Doc and she thinks it's
Eczema. She said its common with asthma?

This was my first thought. DD2 has food allergies and has struggled with eczema since she was 2 months old. I've noticed she's flared up recently as we've closed the house up for the winter and she's exposed to the dry air. I started her skin regimen up last evening, in fact. I take her out of the tub, pat her dry and coat her with aquaphor, paying special attention to the areas with dryest skin. She had the trademark red, rough bumpy rash on her hip last night. If the itching is uncontrollable, we do use a prescription 2% hydrocortisone and that usually helps stop the itching and heal the damage pretty quickly but we try keeping her skin moisturized to aviod requiring the hydrocortisone.

Melissa (Bubbaray) used to be the BEST resource for eczema on the BBB. I miss her for that some days.

[Melbel]

I feel like this problem on his elbows/knees/bum is probably eczema. He's had dry skin here before, but never this bumpy. I have been putting cream on it and will continue to do so every morning and night to keep it moisturized. But it doesnt seem like this would be Lyme related. He's had asthma issues since he was 9 months old so I dont think his asthma is related to any tick bite. He's only gets symptoms when he is sick with a cold/stuffy nose/runny nose...the rest of the time he fine and doesnt need asthma meds unless he has a cold.

I guess I am just not convinced that the tick could have anything to do with it? Plus his doc did not seem inclined to do anything about the tick bite. I realize she's not a Lyme expert, but I do like and trust her. And without specific symptoms of Lyme I feel silly demanding she treat him for lyme I guess.

It may or may not be related, I agree. I did feel as though there were decisions made by your pediatrician based upon common misconceptions (i.e. duration of attachment, requiring a bullseye rash). Even without any symptoms at all, prophylactic treatment is becoming more of the norm because (1) more and more ticks are testing positive for various TBDs; (2) early testing is very inaccurate (missing up to 75% of actual cases per a Johns Hopkins study); (3) early symptoms can be subtle; and (4) a disseminated Lyme or other TBD is much more difficult to treat and there is a risk of permanent damage.

Approximately 50% of reported cases of Lyme disease indicated the patient did not have an EM (bulls-eye) rash. Nationally, less than 10% of children report a rash (Dr. Jones, CT). http://www.drjoneskids.com (this website also show a wide variety of rashes).

Leading Lyme doctors have recommended prophylactic treatment for years. IDSA doctors are finally coming on board as well. Even the most well meaning, kind and great pediatricians often do not keep up with the latest research and trends for every condition (which we learned very much the hard way). Parents often have to be advocates.

[khalloc]

I understand what you are saying about Lyme. Its pretty scary! What antibiotic do they use to treat lyme in a case like this? I saw something about a 28 day treatment cycle? Are their side-effects to that at all? I can always bring DS back to the pediatrician with the rash issue (if the cream is not clearing it up) and talk to her again. I did use some hydra cortisone cream that I had in a travel packet on Saturday night, but since then I have been using a tube of First Aid Beauty Ultra Repair Cream.

He has had bumps and dry skin issues before, but I've never seen the bumps this pronounced and itchy. It has been less itchy for him since we started putting cream on it.

Thank you!

[Melbel]

I understand what you are saying about Lyme. Its pretty scary! What antibiotic do they use to treat lyme in a case like this? I saw something about a 28 day treatment cycle? Are their side-effects to that at all? I can always bring DS back to the pediatrician with the rash issue (if the cream is not clearing it up) and talk to her again. I did use some hydra cortisone cream that I had in a travel packet on Saturday night, but since then I have been using a tube of First Aid Beauty Ultra Repair Cream.

He has had bumps and dry skin issues before, but I've never seen the bumps this pronounced and itchy. It has been less itchy for him since we started putting cream on it.

Thank you!

You are welcome. I am not trying to scare you, but rather, provide information to make an educated decision. As we have learned firsthand, as well as through the countless stories of others, most doctors tend to miss Lyme Disease or under vastly estimate the risk of transmission. Based upon the nightmare we experienced, we now consider the failure to prophylactically treat an embedded deer tick tantamount to playing Russian roulette. IMO, the risk of disseminated Lyme (or other tick born disease) is much greater than the risk of 28 days of antibiotics. Each family will need to make their own choices though.

For children under 8, Doxycycline (the most common antibiotic for Lyme) is contraindicated because it may stain permanent teeth. Instead, doctors tend to prescribe Amoxicillin for younger children (50 mg/kg/day divided into q8h doses). See page 18: http://www.lymenet.org/BurrGuide200810.pdf

If you are returning to the pediatrician, I would print the resources I linked in this thread. Your pediatrician may or may not have an open mind. Our pediatrician for our son was initially reluctant to consider the ILADS standard of care (vs. the CDC/IDSA conservative approach), but has come around after seeing DS' improvement (in addition to seeing his Western Blot that lit up like a Christmas tree after several months of treatment compared to his initial test only showed a few positive bands).

[khalloc]

I wanted to post an update -

Last Tuesday I brought DS to the pediatrician for this rash. I mentioned being worried about the tick bite again. She looked at the rash and didn't think it was related to the tick bite. She said it could be viral but didn't look exactly like whatever viral rash she was thinking off (I forget the name). She said it could be eczema. She wrote a prescription for a steroid cream to use 2x a day for 14 days. She also listened to his chest since he's had some asthma things lately and needed his nebulizer. He sounded fine. Then she looked in his ears. He had a double ear infection! So we did azithromyacin for 5 days for that.

Fast forward to today. I was picking him up from daycare and mentioned to the teacher that I brought him to the doc for a rash on his knees and elbows and he ended up having a double ear infection. His friends mom overheard us and her DD just came down with the same rash on her elbows! So I guess that means its probably viral like the doc said. I am relieved that someone else has the same thing so it's probably not Lyme..