Toddlers: 12 - 24 Months

Question about a rash and PIP

My DS developed this rash literally over night. It's been a little over 2 weeks that he has had it. We have seen the family doc, pedi, and a dermatologist. The dermatologist isn't too sure what it is sent me home with a hand written piece of paper of 6 different things it could be and told me to look it up online SERIOUSLY! I have never had a MD tell me to do this. I have had them tell me not to but not to do so. 

Well nothing he wrote down matches up. It is not dermatitis according to this doc or eczema. He also said that in order to fully know what it was he would have to do a biopsy. Well after telling me to go look it up online and let him know what I decide we found a different dermatologist and we will be seeing him on the 16th. 

I just wanted to post a pic here to see if anyone else has seen this, experienced something similar or just feedback in genral. TIA

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Re: Question about a rash and PIP

  • I don't know what it is but I just want to say I'm so sorry for you and your LO. What a clown of a doctor.
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  • Is it raised? itchy? bothersome?

    It looks like a birthmark in the photo but, that's odd that it just appeared.

    Both my boys have/had eczema. I think the shoulders are a common place for patches but, usually they would appear elsewhere as well. At least that was our experience.

    Good for you for seeking a 2nd opinion. That first doctor seems a little out there. image

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  • It is raised, doesn't seem to bother him or itch. 

    The birthmark thing we thought about too but how could it just appear..

    He has eczema on his cheeks but a week of hydrocortisone cream and cetaphil didn't seem to change it either.

    I cannot wait for the second opinion!  

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  • could it be ringworm? this is it on a man? not sure, but good luck!!

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  • No the pedi was pretty sure it wasn't ringworm and so was the quack derm lol 

    Not sure how much I trust that guy. One of the things he said it could be was connective tissue nevus.. But when I look into it it doesn't look the same and my pedi and I talked after I left that derm's office and she wasn't sure either. 

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  • I'm a pediatric dermatology PA at a children's hospital. It does not look like a rash to me (but then again, it's REALLY hard to tell in the picture). It def. does not look like eczema, ringworm, herpes, etc..especially since it does not itch and hydrocortisone is not helping it). Birthmarks can come out at any age. Is the hair in it slightly bit darker or more than the rest of his back (i.e. Becker's nevus). When you rub it, does it get red and raised (mastocytoma)? I agree with the derm you saw, I'd probably biopsy it too. If you can tell me more symptoms, colors, texture, etc. I may be able to help you more.
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  • imagejdreams76:

    No the pedi was pretty sure it wasn't ringworm and so was the quack derm lol 

    Not sure how much I trust that guy. One of the things he said it could be was connective tissue nevus.. But when I look into it it doesn't look the same and my pedi and I talked after I left that derm's office and she wasn't sure either. 

    I must have missed this...a connective tissue nevus is the same thing as a Becker's Nevus that I mentioned in my post above...I really do agree. They come out after birth and start as a light brown adn eventually darken. The usually have more/darker hair in them. It's a gradual process though and unfortunately, you won't know 100% without a biopsy. I see about 50 kids a day (on my own) and probably perform about 10-15 biopsies a day. It's really not hard to do and is very fast! I took off 2 irreg. moles on my 4 year old niece a few months ago and she's a drama queen and was fine.

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  • We are going to go through with the biopsy for sure when we see this next derm. I was just nervous after I saw the previous one and felt lost and confused. 

    Now is Becker's Nevus something I need to worry about? Will he continue to get these? He has something similar on his face that he has had since birth it's very small and just right next to his ear in his hairline he called that nevus sebacceaus. This thing he has on his arm popped up literally overnight I gave him a bath one night and then it wasn't there and the next evening putting on Pj's it was on his arm. When we look back at photo's from the day before it showed it you can't see anything that would look off on his arm it's just so weird! Versus the thing on his face when he was born was like a big red spot and then it got smaller and just lighted up to about the color of skin slightly more yellow. 

    Also the thing on his arm kinda looks like he has small little bumps in it. I will take a better photo if I can tomorrow and post it again. 

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  • Not sure if you can see it better in this photo but here is another shot of it.

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  • It is really hard to tell without looking up close, with my dermscope, and feeling the texture, etc. But a Becker's Nevus (or connective tissue nevus) is NOTHING to worry about at all. It's nothing bad, won't hurt it, nothing. We call birthmarks, "birth"marks because they are programmed in the DNA to come out at a certain time (usually around birth or within the first few months/years.

    Now on the other hand, what are you planning on doing about the Nevus Sebaceous? I'm not sure what your pedi or derm said to you about that, but we recommend complete removal by plastic surgery before puberty. A small percentage of N. Seb's can become cancerous around puberty. But don't worry, they usually turn into basal cell cancer which is NOT deadly or cause any problems. BUT you still want it removed. No rush, we usually recommend around 2 or 3 years just because before, they are too little and later it is hard to get a kid to go to the hospital for a minor surgical procedure.

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  • i think it's ezcema...my husbands has patches like that on his back- looks horrible but they don't even know it's there.

     I'm in MN too and it's no wonder these eczema patches pop up- with the frigid cold and blasting indoor heat.....aaagghhhh..SO sick of it.

    GL! 

  • imageg8orell:

    It is really hard to tell without looking up close, with my dermscope, and feeling the texture, etc. But a Becker's Nevus (or connective tissue nevus) is NOTHING to worry about at all. It's nothing bad, won't hurt it, nothing. We call birthmarks, "birth"marks because they are programmed in the DNA to come out at a certain time (usually around birth or within the first few months/years.

    Now on the other hand, what are you planning on doing about the Nevus Sebaceous? I'm not sure what your pedi or derm said to you about that, but we recommend complete removal by plastic surgery before puberty. A small percentage of N. Seb's can become cancerous around puberty. But don't worry, they usually turn into basal cell cancer which is NOT deadly or cause any problems. BUT you still want it removed. No rush, we usually recommend around 2 or 3 years just because before, they are too little and later it is hard to get a kid to go to the hospital for a minor surgical procedure.

    Thank you so much for all the information. I wish now I would have posted this last week when I left that derms office just get some reassurance etc from you! You have put my DH and I at ease a bit tonight. Here we have been reading only about connective tissue nevus and all the other things that go with it and kinda just left wondering what it does and what will happen to our DS. 

    The N.seb as you called it on his face we have known since birth what that was and we have discussed it with our ped and also that derm about removal. I'm hoping to get more information about what steps we need to take toward that on the 16th as well. I will defiantly take a closer pic of this tomorrow and post it on this thread or PM you with it. Thank you again for all the information! Like I said I wish I would have came on here right away but at the time it was kinda hectic on this site around that time..

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  • You're welcome! Neither the Becker's Nevus or Nevus Sebaceous are anything to worry about! The Becker's Nevus is purely cosmetic. Some people don't like their appearance, so we'll laser them, etc, but again, purely for cosmetic reasons. Def. consider complete removal of the nevus sebaceous on his face...I would see a pediatric plastic surgeon for that since it's on his face. But again, you don't have to worry about that until puberty...although like I said, it would be easier while he's younger. Def. PM me with a clear picture tomorrow! And try not to worry!! Most derm things are NOT harmful (which is why I went into pedi derm...rather than another pedi specialty)!
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  • Sorry about the typos and being all over the place...I'm typing with one hand while feeding DS and then both hands when he takes a break (he's a LAZY eater, LOL). Well I'm off to bed b/c I'll have to get up in 3-4 hours and feed him again!
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    Camryn Grace ~ July 6th, 2009 ~ 7lbs 9oz, 20.5" Lilypie Third Birthday tickers image
    Brayden Richard Drew ~ December 20, 2010~7lbs 9oz, 20" Lilypie Second Birthday tickers
  • g8orell~ I sent you a PM with more photo's in it that I took today. I think they may come up bigger. Let me know if they work. 
    TIA
    TTC #3 since June 2011. Lilypie Third Birthday tickers Lilypie Kids Birthday tickers
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