Resolved question:
My 6 year old daughter has a skin condition that started out months ago with impetigo on her finger. After that was cured, she started developing spots of red scaly skin on her body. At first this was diagnosed as impetigo as well, then later as eczema. In the meantime she's had three bouts of strep throat as well. We've had courses of Amoxicillin, a penicillin shot (for strep throat) as well as applying triamcinolone cream daily (2x) to the spots. She's also just started a course of gris-peg 250mg tablets. None of this is working and the condition seems to just keep getting worse. She has spots on her back, stomach, outside of her leg, outside of her arm, a patch on the inside elbow area and all over her scalp and random other locations. I've attached some pictures. I have an appointment for her on June 8th with another dermatologist but this is the soonest that I could get an appointment and that's in a town 4 hours away. Can I continue to wait for that appointment or should I be pushing with her pediatrician for some other course of treatment.
Submitted:
4 Days
Category:
Dermatologist
Hello,
Thanks for posting your query at DoctorSpring.com
I can understand your concern.
This seems to be a case of guttate psoriasis. It is a type of psoriasis where there are crops of scaly plaques all over the body. Its not contagious.
Guttate psoriaisis is a scaly condition which starts of as an acute condition, which is triggered after 2 to 3 weeks of streptococcal throat infection, It usually doesn't recurr but it could at times form chronic plaques.
The treatment usually involves giving an antibiotic like erythromycin and phototherapy.
I would recommend a visit to the dermatologist to start the treatment. Its ok to wait till you get the appointment if you have no option. But if its possible to expedite the appointment , it would be better as there might be a crop of many more lesions in thext 10 days. Meanwhile you can continue with the treatment that your doctor has prescribed.
Please let me know if you have any queries.
Take care
So if this has been going on for 5 months it's apparently a chronic condition. Should I get her tested for strep again, just throat or blood test? It seems like the antifungal is now giving her hives so I've stopped giving her that medicine. People think the spots look like chicken pox. I've uploaded more pictures of scalp and better pictures. So amoxycillian won't touch the infection and I need to ask for stronger meds? How do I tell the doctor this info without them getting offended.
Hello
Thanks for your reply.
There would be no need to get tested for streptococcus. The eruption called guttate psoriasis isn't infectious directly but there is an eruption following streptococcal infection. Erythromycin world's the best for it. I haven't received any pictures yet that you have sent. Please resend it.
You could discuss it with your doctor, there is no reason to be offended.
Take care
The pediatrician disagreed with the idea and the request for erythromycin. No worries going to dermatologist on Tuesday. Hopefully they'll be more reasonable and I'll look for new ped. Thanks for your help
Hello,
Please get back to us after your appointment. We are glad to help.
Thank you
The dermatologist prescribed Rifadin and said to finish last 5 days of amoxycillian and also gave liquid prednisone. 3 tbsp for 1 week, 2 tbsp for 2 weeks, the 1 tbsp for a week. It's been 6 days, we've finished amoxycillian and Rifadin still using ointment and prednisone but see no visible improvement. How long do I wait before calling the doctor back? Follow up isn't for 2 months.
Sometimes results may not be evident till a couple of weeks to a month in some cases.
Some improvement can be noticed 2nd week onwards.
You can call the doctor if there is no improvement after 2 weeks.
Regards.