Dr. Ashwini. V. Swamy
Venereology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My 8-year-old daughter has something on her skin. It started about five weeks back with a little red spot on her inner thigh. Initially, it was a bit dry inside. Later, surrounded by a ring-like shape. Now, it has become big. She got Daktarin for ringworm treatment but it did not help, and after a week the spot got even bigger and changed the color to purple. In the meantime, she was getting new red spots. We went back to GP, and she got Hydrocortisone as a change in treatment. Still no results and new spots are showing up.
After a week, we came back to GP, and she got the antibiotic Flucloxacillin. There was no change. Yesterday, a swab was taken, and she got Permethrin cream, and I cannot see the results. I am cleaning her with Hibiscrub for the last five days. There is no itchiness, discomfort, or discharge.
Hi,
Welcome to icliniq.com.
I saw the picture (attachment removed to protect patient identity). Few rashes look like Pityriasis rosea. It is a self-limiting condition, usually seen as a reaction to viral infections, some oral medications can also precipitate Pityriasis rosea. It starts with the mother patch, which is the biggest patch that appears first. It presents with red round rash with scales at the edges; we call it collarette scales which is very classic of Pityriasis rosea.
After the mother patch appears, daughter patches follow it. It will be seen on arms, neck, chest, back, and thighs. Each lesion will appear round to oval in shape, with scales at the edge. Sometimes, red bumps are also seen (papular Pityriasis rosea). The peak of rashes (maximum number of rashes) will be around the 4th week, and by the end of 6th to 8th week, rashes start subsiding.
Fungal infections (tinea) are very itchy. Fungal infection presenting without itching is very unlikely. Though rashes look similar. In scabies, rashes will be intensely itchy with red bumps over finger spaces, wrist, armpits, around the belly button, and groin. I would like to know that did she have a fever, cough or sore throat before the rash. Is she taking any oral medication? Does anyone else in the family have similar rashes? Any changes in the routine skin care products, like body lotion, powder or detergent? Do you have pets at home and are these pets ticks free? Can you also upload some clear pictures of a single rash so that I can appreciate all the finer details?
Patient's Query
Thank you doctor,
My daughter had a cough a month back for a few weeks, and I thought it might be viral. Before Christmas it was difficult for her to breathe so she was given some pink tablets of steroids to dissolve in water for five days and asked to start using a brown asthma inhaler- preventer Clenil modulite 100. She has asthma and has been using a blue reliever inhaler for a long time.
Still, with the brown inhaler, she had spells of catching deep breaths a few times a day. And starting about a few days after the new inhaler, the red spot appeared. I stopped the inhaler yesterday as I always thought it might be a side effect. I have not changed anything in our routine. We have a cat. He goes outside only for a few minutes to our garden and comes back home. I do not think he has fleas or ticks. I will start using special products on him. Only she has the rash even though we are using the same towels.
Is the condition dangerous or contagious? Should I apply anything on it or just continue with Hydrocortisone or Hibiscrub?
Hi,
Welcome back to icliniq.com.
Yes, this is Pityriasis rosea. It is an inflammatory condition. Not at all dangerous or contagious. It is self resolving. You should see all the rashes resolving in another 2 to 3 weeks. It is a reaction to viral infection. It could be any virus. However, the most commonly associated virus are HHV 6 and 7 (human herpesvirus). It does not spread from one person to another person.
In other words, I can say Pityriasis rosea is an allergic reaction to previous viral infections. Start applying topical Calamine lotion in the morning. Continue to apply Hydrocortisone 1% cream to the rashes at night for not more than 2 weeks. Hydrocortisone is a low-potent steroid. Hence, these topical steroids can be safely used for 2 weeks. Also, use a mild soap like Dove for bathing.
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Venereology
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