[NP-Clinical] Derm/Peds question

[Theodore Scott]

Good Morning Kim,

 

Sorry for the delayed reply as I am just getting caught up on my e-mail this
morning.  Based on the information presented I would still go with viral
exanthum.  Unless this spreads or becomes vesicular I would just treat the
underlying viral URI and this will clear by itself.

 

Ted Scott NP-C

 

  _____  

From: np-clinical-bounces at nurse.net [mailto:np-clinical-bounces at nurse.net]
On Behalf Of Kimberly Spering
Sent: Thursday, January 18, 2007 7:10 PM
To: np-clinical at nurse.net
Subject: [NP-Clinical] Derm/Peds question

 

I have a request for help from anyone in peds or derm (Ted, help please?).
I think I'm being an over-reacting Mom here, but my 4 year-old son came home
today with an odd, localized rash only on his left lateral neck area...and
derm is not my stellar subject.

 

He has had URI symptoms for over a week; this afternoon he broke out in a
rash that is localized only on his left lateral neck, about a 2-inch area
total.  It is mostly a macular, pinpoint pink rash (very, very slightly
raised later this evening).  No known bites, contact dermatitis, or injury
per his day care teachers.  He felt warm-to-touch last evening but no fever
until tonight--he started with a temp of 101.2 orally, complains of
headache, "eyes hurting," and joint aches.  No nuchal rigidity, n/v, or
change in LOC.  No other health issues since having ear tubes, which fell
out over 1 year ago.  Being the over-reactive Mom, I of course assumed the
worst and went looking up rashes associated with meningitis--but found that
most were a vasculitis-type phenomenon--definitely NOT what I'm seeing here.

 

The only viral rashes associated with a URI that I ever saw in family
practice were generalized, or truncal/limb involvement.  I've never seen
anything like this one, and checking on Ted's four derm sites and in three
books were futile.

 

Any help would be most appreciated, so I know if there is anything to worry
about.  (Sorry--this is my baby!)

 

Thanks in advance~

 

Kim Spering

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