Doctor said toddler has allergic rash, but should I get a 2nd opinion?
October 20, 2014 8:28 PM   Subscribe

My 18 month old son developed a rash 3 days ago. Photos here. We are currently on holiday on Koh Chang, an island off of Thailand. I took him to the local hospital and the doctor told me that it looks like an allergy, possibly to something in the sand, and to just leave it alone and not put anything on it. However, I'm still worried.

The rash is all around his neck, the top of his chest, both arms, and a bit around his jawline. On his chest, it starts out red and close together with only a few white bumps on his lower abdomen. There is nothing on his lower back, diaper area, or legs. If it was an allergy to something in the sand, wouldn't it be on his legs as well?

A bit if background: On the 11th, he had a very high fever, and we took him to a hospital in Bangkok where he was diagnosed with tonsillitis/strep throat (without a test for strep). He completed a 7 day course of Augmentin ES. At the followup visit, the doctor said his tonsils looked fine and he was clear to continue our trip.

Since finishing the antibiotics, he had seemed very well with no fever, diarrhoea, or any other symptoms. He acts happy and playful.

The only thing I can think of that could have caused an allergic reaction is the sunscreen I put on him the day before he broke out in the rash. It was Soltan Kids which is marked hypoallergenic. I only put it on his arms and legs, not his face or chest.

Should I take him back to Bangkok (6 hours away by bus) to see a different doctor? Maybe I am worrying too much but he is my first child and he had never been ill before the tonsillitis so the whole incident really scared me.
posted by Ariadne to Health & Fitness (26 answers total) 1 user marked this as a favorite
My son had a similar unexplained rash, but it was all over his body, so it may be different. He also got it several days after a high fever. The rash started local to his crotch, but ended up being everywhere. It took several days to migrate all over. It took many doctor visits, but we finally got a diagnosis of gianotti-crosti syndrome. Not life threatening; in fact, his only discomfort was some slight dryness. Check out more online and see if that looks like what your kid has. When I looked up pictures, it looked VERY similar to my child's rash. If your kid has that, worry not. It takes a while, but goes away on its own.
posted by Pacrand at 8:39 PM on October 20, 2014 [1 favorite]

First of all and most importantly: remain calm! Really it doesn't look that bad to me. (I am in no way a medical professional.) Is there no other doctor on the island from which to get a second opinion?
posted by trip and a half at 8:42 PM on October 20, 2014

Best answer: I also meant to add that, like your son, I also have very fair skin, and when I was his age simple exposure to the sun would cause a very similar reaction in me.
posted by trip and a half at 8:44 PM on October 20, 2014 [5 favorites]

The timing is right for it to be a reaction to the antibiotic. I'm not diagnosing your child but just letting you know that when my son had a reaction to an antibiotic it looked just like your son's rash. It also looks quite similar to the heat rashes my kids used to get when they were little.

If there truly is no other doctor, I think this can wait. Assuming he is current on all the recommended vaccinations for his age, of course.
posted by cooker girl at 8:45 PM on October 20, 2014 [1 favorite]

Mild skin rash is a side effect of Augmentin. The rash started 3 days ago, and he just finished the augmentin on the 18th? It's a possibility. google image search results look comparable.
posted by pintapicasso at 8:46 PM on October 20, 2014 [1 favorite]

IANYD. I cannot give you or your son medical advice.

I will just say that looking at his photos prompted me to search whether swimmer's itch was something that happens in Thailand, and it is.

A drug rash can look similar, although his rash seems to have specifically started after finishing the antibiotics. Also, a drug rash usually looks more like hives than pustules/papules.
posted by treehorn+bunny at 8:48 PM on October 20, 2014 [2 favorites]

Ah! treehorn + bunny has reminded me that when I was little and got the similar thing, some people also called it "swimmer's itch".
posted by trip and a half at 8:52 PM on October 20, 2014

Heat rash?
posted by littlewater at 8:54 PM on October 20, 2014

Are you confident it isn't standard heat rash?
posted by DarlingBri at 8:55 PM on October 20, 2014 [2 favorites]

Response by poster: He has not been vaccinated for chicken pox as our paediatrician does not routinely give that vaccination until they enter nursery school. However, the doctor said that it did not look like chicken pox and it does not appear to be causing any itching.

I know that there are probably dozens of childhood rashes that look like this one. I guess I am most concerned that it could be something serious related to the strep throat. I even asked the doctor about scarlet fever and he just laughed at me and said the tonsils looked fine and he did not have the characteristic red tongue associated with that.

I promise not to babysit this thread. I just want to make sure there isn't some big warning sign I am missing that means I need to get him back to a doctor immediately. Thanks for the answers so far.
posted by Ariadne at 9:01 PM on October 20, 2014

Best answer: To avoid jargon, if you google image search hives (urticaria), you will see generally how they look different from small white raised bumps (pustules) and small red raised bumps (papules).

Prickly heat or heat rash also appears as pustules or papules so it can look quite similar as well, although it typically is most prominent in areas with a lot of sweat glands or sweating, like the underarms/groin/skin folds, depending on the clothing being worn etc.
posted by treehorn+bunny at 9:02 PM on October 20, 2014 [2 favorites]

For scarlet fever, one not only has a rash, but also a fever (as well as the other physical findings your doctor mentioned). You might have been thinking of rheumatic fever, which occurs after strep throat - rheumatic fever is very rare in people who have been treated with antibiotics for strep, and also it generally involves fever, rash, and a number of other symptoms like joint pain. I hope that information is useful.
posted by treehorn+bunny at 9:11 PM on October 20, 2014 [1 favorite]

Best answer: I know how it is to worry about your child as I am also the mother of a toddler. I should also add I noticed you mentioned chicken pox - chicken pox is a blistering, and yes, quite itchy rash (i.e. bumps filled with clear fluid, although you can also see pustules, and it typically gets scabby when the person itches the spots). Also there is usually no treatment for chickenpox except treating the symptoms.

Warning signs could include: him appearing ill/lethargic/listless, more fevers/chills, decreased eating and drinking, dry appearing mouth, him appearing to be in pain (i.e. headache, abdominal pain, etc). I have to get to bed but hope his rash clears up and you enjoy the rest of your vacation!
posted by treehorn+bunny at 9:24 PM on October 20, 2014 [1 favorite]

Can you email photos to your own pediatrician at home for advice?
posted by judith at 9:25 PM on October 20, 2014 [1 favorite]

Response by poster: Judith, that's a good idea but our pediatrician doesn't do email.

Everyone else: I'm keeping my fingers crossed that it is just heat rash and will be moving into an air conditioned room this afternoon.
posted by Ariadne at 9:42 PM on October 20, 2014 [1 favorite]

Best answer: If it was an allergy to something in the sand, wouldn't it be on his legs as well?

I can't speak to any other cause, but when I get an allergic rash, it only typically involves certain parts and not others. I get it most on my face, neck, forearms, and calves. I don't think I've ever had hives anywhere else - and I'm allergic to so much crap - anyway, based on my experience, don't take the location of the rash as particularly meaningful when it comes to allergies.

His rash looks like the one I get when I play in the grass with the dogs, or my wife tries a new laundry detergent. Which is to say, it looks like an allergy or reaction to me. This is advice on the internet, so, usual warnings apply - but in your case, I'd probably try a good shower/bath and some benadryl and see how that goes.
posted by Pogo_Fuzzybutt at 9:45 PM on October 20, 2014 [1 favorite]

Just anecdotal comments here, no medical advice; it looks very similar to the rashes that three of my kids used to get on occasion... allergic hives, sometimes with identifiable cause, but most of the time not. If you have access to Benedryl or some kind of antihistamine that you can give him, try it for a dose or two. If it disappears or lessons while the Benedryl is in his system, you'd have an answer for *what* it is, even if you can't verify the cause.
posted by stormyteal at 10:02 PM on October 20, 2014 [1 favorite]

Nthing probably heat rash or a sun reaction. If the high fever comes back, then I'd consider heading back to the hospital.
posted by amaire at 10:07 PM on October 20, 2014 [1 favorite]

My workplace health insurance has a 1800 second opinion phone line. Perhaps check if you gave this, OE your travel insurance does.

My thought is that if it doesn't go away and is causing you stress a second opinio . Might help you enjoy your vacation, even if it turns out not to be warranted.

Or you could phone the Bangkok hospital to speak to the doctor you saw before to see if they worry because of previous diagnosis or medication.
posted by chapps at 11:36 PM on October 20, 2014

Pale person with reactive skin chiming in to say that while IANAD, your kiddo's skin looks like what mine does in response to weird sunscreen, occasional sun exposure, or fragrance-containing laundry detergent.
posted by deludingmyself at 3:22 AM on October 21, 2014

Best answer: Oh, and while Pogo_Fuzzybutt's advice is good, if it is an allergic skin reaction even all of those things aren't going to make it go away immediately. I've got some spots from evil laundry detergent right now (I'm on vacation, too, comes with the territory), and they're only really starting to reduce in redness here on day 4.
posted by deludingmyself at 3:27 AM on October 21, 2014

Both my kids have gotten a mild rash like that for any number of reasons. Googling "toddler rash" has got to be the worst thing to do - they all look the same! But I would agree that if there's no fever or lethargy he's likely fine and doesn't need to be seen again.
posted by checkitnice at 3:56 AM on October 21, 2014

I know she didn't explicitly say it, Treehorn+Bunny is an ER doctor. Her advice is not only wise coming from a fellow parent, but also medically relevant.

Put whatever the doctor there gave you on the rash, let your little one run around bare-assed, and enjoy the rest of your trip.
posted by Ruthless Bunny at 5:48 AM on October 21, 2014

It could be Pityriasis Rosea. Looks odd, not always itchy, and will take a while to go away, but is harmless.
posted by monopas at 10:07 AM on October 21, 2014

Response by poster: Thanks everyone! We moved into an air conditioned room at a different hotel and the rash was looking 50% better by that evening. I don't know if it was heat rash or an allergy but I've changed sunscreens and we will stick to air conditioned rooms from now on. Your answers really helped to calm my nerves.
posted by Ariadne at 11:50 PM on October 21, 2014 [1 favorite]

Late to the game, but your son's rash looks very much like the rash my husband gets from a combination of sun, saltwater, and sweat. He spent our entire honeymoon (Cayman islands) looking like that.

IANAD, but my rule of thumb when it comes to my kids is that if they're happy, playful, and unbothered, it's unlikely that you need to panic.
posted by telepanda at 7:43 AM on October 22, 2014 [1 favorite]

« Older Do I meet my catfish?   |   I need help figuring out reps and sets with a... Newer »
This thread is closed to new comments.