Dr Raley's Blog

Drug Rash

This is a little girl who had an allergic reaction to Amoxicillin.  Parents will often say that their child has a rash with an antibiotic and wonder if they are having an allergy.  This is a classic case of "urticaria or hives" from a drug allergy.

My rash is better than yours

A mom sent this to me-the challenge is on-can anyone top this?  By the way, this went away in a few hours-who knows what the cause was?

I went to OKC last night to see Snow Patrol at the Zoo.  Good concert, great venue.  I never thought that I would say this but OKC sure does have a feel that Tulsa doesn't.  It used to be that Tulsa was "the city" of Oklahoma-but I think OKC has passed us by.    However, the stuff down at the RiverWalk is pretty cool and the new arena downtown along with maybe moving the ballpark downtown would be good.  Any excuse to get down to McNellies.

Hives

I will often see kids with hives during this time of the year.  This rash will present with a rapid onset.  Some kids will say that they are very itchy, while others will not even notice them.  The cause is usually unkown, however, new exposure like antibiotics, foods, soaps, etc can also be the culprit.  The rash will sometimes "come and go" and can last up to 2-3 weeks, but usually goes away after a few days.  Bendaryl will help with the itching.  If your child has joint swelling or swelling of the lips associated with this rash they need to be seen. 

Diaper rashes

  I see many different diaper rashes and here are a few examples of some pretty severe diaper rashes-each from a different etiology (cause).  The one on the far left is a newborn with severe diaper dermatitis from frequent stooling.  This responded well to a RX cream called Biafine and changing over to cloth diapers for about 1 week.  The second from the left is a staph diaper rash that responded well to a oral antibiotic and the one on the right is a "classic" yeast infection that required an oral antifungal.

Most diaper rashes are not this severe.  General care includes frequent changing and applying a topical barrier like vaseline or destin after each diaper change.  Sometimes stopping a diaper wipe and just using a wash cloth will be sufficient. 

Scarlet Fever

I am seeing some rashes in my office over the past few weeks.  The most common has been scarlet fever-the rash associated with the bacteria that causes strep throat.  However, not everyone who has scarlet fever will have a fever or sore throat.  The bacteria, Group A beta-hemolytic streptococci, can often release a toxin that causes the a red sandpaper rash most likely on the trunk and in the groin.  Some kids may also have peeling of the hands and feet about 10 days after the onset of the rash. 

Kids are contagious with the rash and need to be treated with antibiotics.  Many parents and grandparents are worried with the mention of scarlet fever.  This strep bacteria can cause some problems with the heart-not very common now, but very common before penicillins were discovered.  This is why it is important for me to see most rashes. 

molluscum

As many of you with older kids-molluscum contagiosum-what I often refer (jokingly) to as the "plague of South Tulsa" (see picture) is a rash that just appears out of nowhere. Usually starts as small little bumps that have a "small core".  Often appear on the trunk and can rapidly spread. More common in kids with eczema.  Often contagious in the family-unlikely for adults to get.  There are multiple treamtment options: some painful, some not, many not very effective.  Most of these bumps will go away after about 6-9months with no treatment.  Try to be patient if your child gets these-however this is difficult.