Help me identify rash on DS's face (pic included)

[sunwise]

Hi everyone,

My DS (11 months old) has had a rash for about a week now. He saw the pediatrician twice last week - last Monday I took him in because his eyes were gunky, and the ped diagnosed pinkeye in both eyes. (Prescription drops cleared that up in a few days.) At the time, he also had a mild face rash - it looked like large pimples in a few places on his face. The ped thought it might be impetigo because one or two of the pimples had the characteristic honey-colored crust (but they were still very small - not much larger than a pimple). At the time she told me to put on Bacitracin ointment 3 times per day to see if it cleared up from that.

By Wednesday, the Bacitracin was clearly not working because the rash was spreading. The rash was still only on his face, but the pimples had turned into larger, slightly raised red areas. A few of them had a honey-colored crust like impetigo, but most did not. I never felt any oozing - the rash was always very dry to the touch. Took DS back to the ped, who put him on prescription Cephalexin for probable impetigo. We stopped the Bacitracin and are now doing just the oral abx.

So, by this morning (5th day on abx), I really expected to see things getting better, but in looking over pictures from the last few days, the rash is not getting better and is maybe even a little worse. The raised red patches are a bit more extensive and there might even be new pimples forming. The rash is still contained on his face only. Rash is still very dry, and since he started the abx, there is also some flaky white skin coming off the rashy areas. There are still 2-3 spots on his face with a honey-colored crust, but that's it.

Any other potentially relevant info - he has been acting and eating normally, no fever, and he doesn't seem itchy. The rash has not been transmitted to either DH or myself. We are also treating DS for a yeast diaper rash right now (with lotrimin cream), but I mentioned that to the ped last week and she didn't seem to think there was a connection. The rash is only on his face, but I have seen a few tiny bumps elsewhere on his body (mostly at the waist area). I do not think they are related as they have either gone away or stayed the same for the past week. He and I have both had a very mild cold this week, with some minor coughing and sore throat.

We are seeing the ped later today. My fear is that this is not impetigo and we have been unnecessarily giving him abx, but I will continue them unless the doctor says to stop. In the meantime, have any of you seen a similar rash? Below is a picture of DS that I took this morning. Thanks for your help!

[ttcintexas]

I am sorry I am of no help with what the rash might be, but I wanted to say...What a cutie! He is obviously not bothered by the rash with that awesome, toothy grin. I hope you get some answers soon. 

[hedgehogs4]

It doesn't go with the fever but it kinda looks like a tinea rash - google tinea or ringworm - contagious, harmless and pretty easy to treat.  

[hedgehogs4]

Ooops - gettin my posts confused!  Haha - so no fever to mention - still looks fungal to me.  Kids get it from kissing furry animals w/ it, etc.  

[sunwise]

Thought I'd check back in after seeing the ped - she is now thinking it is fungal. So we stopped the abx (thank goodness!) and are now using nystatin cream and hydrocortisone cream. Hopefully this will help clear things up!

[sunwise]

One more check-in in case any future moms are in my position, wondering about rashes. This is our second full day of using the Nystatin cream and we are already seeing a big improvement in the rash. Seems that it was indeed fungal.

Just sorry that my poor boy had to take 5 days of abx before we figured it out!

[DubaiMom2010]

Hi I think my daughter has similar and it has been so distressing!  She was suffering from a bad nappy rash, which she has never had before the one time she got a tiny bit on her bottom the desitin cream cleared it up overnight, and the pediatrician said it was thrush so I also thought they might be connected since it seem strange they have both come and persisted at the same time.  Her rash is a lot angrier than your son's photo and has come on very quickly, one day one little bump and a couple days later it is angry and red and all over her entire face.  I have seen three doctors and they have all said something different (one said viral infection, one said impetigo and the other said due to her red throat - strep test results pending - it was some sort of result from that).  I don't know what to believe and her poor little face is so red and scaly and also more pimply looking in places than that of your son.  BUt she has been on fucidin for 3 days and oral antibiotics for just over 24 hours.  It seems during the day into the evening it looks a bit better but then at night if she is a bit warm in her sleep as she always is a sweaty sleeper in the morning it is so much worse!  I would have thought the cream would be helping by now.  Her appetite is fine, her mood seems fine, everything else seems ok but the rash isn't improving.  Seeing anothr pediatrician tomorrow for a follow up and I think i will suggest the fungal infection/nystatin and see what they say.  Has your son had any scarring at all?  I am spending hours on the internet trying to find something that looks similar and I am so concerned.  Her nappy rash was really bad and similar to yours she had some little marks here and there on her legs from it.  I thought maybe she had touched it then touched her face and it spread?  I know she is on antibiotics now but i can't help worrying that it hasn't been diagnosed correctly and we aren't treating her properly.  Also, they have all ruled out allergies but she did go onto cow's milk about two weeks ago, but it seems odd the rash would be so localised on her face.  They hae all said it is not this but i have put her back on formula just in case.  I think it is an infection of some type, but it doesn't look like the pictures of impetigo i see on the internet.  It's not as scabby as that and it also has a lot of raised little bumps like pimples as well as the larger, flaky lesions like your son had.  Please let me know how you are getting on and if anyone else has any similar stories please let me know  I am so worried and I am not trusting the doctors I am seeing at the moment! Signed....a very worried mom.

[sunwise]

Hi there! Rashes are so upsetting, aren't they? When I originally posted I was so worried, but just so you know, my son is now 15 months old and hasn't had any recurrence of the rash. And no scarring either. If your daughter is acting normally, then try not to worry too much. She will probably get better before long!

You should probably give the antibiotics at least a few days to see if they help. When we were on oral antibiotics before we got the diagnosis of a fungal infection, I was taking pictures of his face everyday to try to spot the tiniest improvements. It was those pictures that really showed me that the rash was worsening despite the antibiotics and led me to take him back to the pediatrician.

If the antibiotics don't seem to work soon, definitely look into a fungal rash - especially if your daughter has had a yeast diaper rash. If you want to explore the fungal theory yourself (without getting a nystatin prescription), you can buy an over-the-counter cream that is called lotrimin or clotrimazole (well, that's what it's called in the US). It is used as an athlete's foot cream, and that would be where you would find it in a drug store. It does the same thing as nystatin. It is also what we use for treating a yeast diaper rash - by the way, if your daughter is still suffering from the bad diaper rash, try some lotrimin cream and see if it helps.

If it is fungal, you may see some improvement quickly. We definitely did. But it can take time to go away completely, and it can recur even while it is healing. It probably took us 2-3 weeks (or more - I don't remember clearly) until the rash was totally gone. And we had to keep applying the cream for a few days after the rash was gone to make sure it stayed gone.

Please let us know how your daughter is doing. And if you have any more questions, let me know!

[SweetSilver]

We have gone through so many rashes recently-- impetigo, ringworm, then scabies and some mystery thing.  First the antifungal, which worked but then stopped working.  Dxed impetigo.  Once the antibacterial ointment didn't work anymore dxed scabies......  Yeesh!  

It never hurts to try lotramin if an antibacterial isn't working, on a small area if necessary in a case like your son's.  Fungal infections are not always itchy.  

Glad to hear this is working.

What a cutie pie!

[DubaiMom2010]

Hi there I am so glad to hear the nystatin worked and your son is better.  Have you had any recurrences?  My daughter's rash eventually did get better with time and we used prescribed hydrocortisone creams called Alfracort and Locoid.  However, she is now 16 months old and has had a very extreme flare up again, worse than last time.  Starting again as a very small patch and blossoming over a few weeks into pimples and now what looks almost like burns and blisters on her entire face, even on her forehead this time.  It is also once again at the same time as a nasty diaper rash which the doctors believe is a yeast infection.  I am convinced they must be connected...  We were prescribed Nystatin roughly 36 hours ago and this has helped on her bottom and initially we saw an immediate improvement on her face, but then yesterday suddenly it flared up and became so much worse, red, raised, itchy, swollen and bumpy EVERYWHERE.  I was at work, but apparently it was after she was given cow's milk to drink.  I am not sure perhaps this is a food allergy?  The doctor had asked that she try soy milk for the time being while results are pending but our nanny gave her cow's milk as she wasn't really enjoying the soy milk and then this happened.  COuld there be a reaction?  She has been formula fed since 7 weeks and the last time we had the rash as well was around the 1 year mark when we tried fresh cow's milk.  I just don't know anymore.  It's so angry and she is so uncomfortable and I dont' know what to do.  Neither my husband's family or my own have any history of allergies at all so this seems unlikely, but I am considering anything at this stage.  If any other moms out there read this and know wht it could be please let me know.  They are currently running food allergy testing and I am going to go for a skin culture on Saturday.  I need some answers!  *desperate*