Saturday, April 2, 2016

A 6 Year Old Child Presents With A Skin Erruption

This 6 year old child initially had a solitary oval patch on his trunk which was treated by the general practitioner with clotrimazole lotion considering it to be tinea corporis lesion. But after 5-7 days the eruption began to spread and affected mainly the trunk, back and proximal parts of upper limbs. It was associated with mild itching.The picture in closeup is shown below:




1. What is the most probable diagnosis?
2. What was that initial solitary lesion?
3. What are salient features of this eruption?
4. How long does this disease last?
5. How one should manage it?

Answers And Discussion:


1. What is the most probable diagnosis?
Answer: It is most probably Pityriasis rosea. It is a clinical diagnosis. It is a benign common eruption of children. Its cause is unknown though a viral infection may be responsible for it.

2. What was that initial solitary lesion?
Answer: Initial solitary lesion is called Herald patch. It may appear on any part of the body and its size varies from 1-10 cm diameter. It is annular and has a raised border and adherent fine scales. So, it is often confused with tinea corporis lesion.

3. What are salient features of this eruption?
Answer: After 5-10 days of appearance of herald patch, a generalized eruption of oval pink to brown slightly raised lesions approximately 1 cm in size with fine scales. They mainly affect the trunk and arms. Some times other parts of body may also be affected. Some lesions may clear central and demonstrate a collarette of scales attached only at the periphery. Long axis of lesions is parallel to cleavage lines of the skin. It produces a classical Christmas tree pattern.

4. How long does this disease last?
Answer: Lesions may come in crops for 2-12 weeks. It heals with some hypo- or hyperpigmentation. One attack of pityriasis rosea results in life long immunity. Second attacks are rare.

5. How one should manage it?
Answer: Usually, no treatment is required except the reassurance regarding its benign and self limiting nature. It may be asymptomatic or associated with pruritis for which oral antihistamines or topical soothing lotion as calamine lotion or emmolients are enough.


1 comment:

  1. Hello, my name is Betty. i was diagnosed of HIV virus 4 years back. Before then, i was dating this Derrick guy. we had something great going on. Our love life only lasted for 8 months. the sixth and seven month of our relationship, i began feeling very weak every now and then. But i never suspected anything until I kept on experiencing different symptoms like having sore throats, constant headache, body weakness e.t.c. I decided to go for a medical check up. I was tested HIV positive. when the doctor broke the news to me, it was as if my whole world had crumbled. it dawned on me then that Derrick has been lying to me. i was very mad to an extent i almost committed suicide. But there was nothing i could do, other than weep and weep. ever since then, i have been spending heavily on medications, going from one medical clinic or the other so I can look healthy. Though since i was a kid, i love herbs a lot. i take herbal tea with grandma while growing so i am quite familiar with herbs. early last year, i was on the internet and on a particular health blog, to check for herbal medication as alternative. I saw many comments and read many testimonies. Until i came across a particular testimony on how Dr.ugo cured a patient from herpes simplex virus using pure natural herbs. i reached out to the doctor because I also was thinking Herpes had no cure. I told him about my HIV status.He encouraged me not to panic that he will help me get my deliverance. he prepared some herbs and sent them to me. The herbs were in four 70ml bottles and I took them morning and night. i used as he directed, and in less than three weeks, i started having appetite to eat plenty of food and i gained back my strength. the fourth week,I consumed all the herbal meds. He encouraged me to go for a test which i did. This time, the result was negative. I quickly contacted the doctor and informed him of the news. I immediately asked him to prepare for Derrick too. He did and sent it. Today, me and Derrick are HIV free. All thanks goes to God Almighty for healing us through Dr.Ugo. if you are having any kind of sickness at all, Dr.Ugo is the right person to talk to and i assure you, you will be glad you did. His email: ugoherbalhome@gmail.com you can also write him on WhatsApp +2348104990619.

    ReplyDelete