Common types of rashes that afflict children
Dear Dr. Donya,
My little girl Kanasta, eight months, has broken out in red spots, which appear to me to be either measles or chicken pox. The treatment proposed by a doctor here is antibiotics, even though there is no apparent infection. I have read that rest and vitamin A with constant liquids are the best thing. And what about bathing her in warm water and powdering her afterward? Maybe with a special antibacterial soap?
-- Ben
Dear Ben,
An eight-month-old with rash may be suffering from one of the following:
1. Heat rash: they appear as fine red spots usually on the neck, head and shoulders.
2. Eczema or atopic dermatitis: they appear as red spots or red patches, moist or dry, and common on the face, cheeks, neck, arms or legs, and they are itchy.
3. Measles: it is accompanied with fever and distinct red circular spots. The first symptoms are a runny nose, red eyes, hacking cough and fever as high as 39 degree Celcius to 40 degree Celsius. After three to four days, large flat red blotches will begin appearing on the forehead and then spread to the other parts of the face, neck and body. Once the rash reaches the legs, the fever usually subsides. It will take about six to seven days to recover.
4. Rubella: it begins with mild fever and swollen glands in the neck or behind the ears. On the second day, there will be rashes at back of the head which will spread downward to the rest of the body as pink or light red spots, two millimeters to three millimeters in diameter. The condition can last for three to five days.
5. Chicken pox: there will be high fever with red spots which will then turn into vesicles (small blisters) one millimeter to two millimeters in diameter. These vesicles will then turn into yellow-like pimples.
6. Roseola infantum: afflicts infants between six and 12 months old. It is characterized by high fever (about 40 degree Celsius) that will usually last two or three days followed by an eruption of rose-colored spots (just like in rubella). The fever will subside the day the rash breaks out.
7. Bacterial infection: impetigo is usually accompanied with mild fever or no fever. The rash turns from red spots (one centimeter to two centimeters) to vesicles or pustules and breaks easily. It resembles an infected wound. Sometimes lesions develop around the nose and because they are contagious, when the child scratches it and touches another area, that area will become infected too.
Nos. 1-6 are viral infections which require no antibiotics. Only bacterial infections require antibiotics.
In your daughter's case, I think she may be having either heat rash, eczema, rubella or bacterial infection -- but not chicken pox, measles or roseola because these are accompanied by high fever.
With the information you have given me, I can only give you the common types of rashes in her age group. To give you a more specific diagnosis, I would need to know what the rash looks like, where it is located, its pattern, if there is fever, and if it is itchy or painful?
How is she now? Treatment of a rash can be different depending on what she has. If it is a viral infection, just leave the rash alone or you can put some calamine lotion on it is itchy. If the infection is bacterial, apply an antibiotic cream or administer oral antibiotics if there are many lesions, lest they spread to other areas. If its eczema or heat rash, just use mild soap or cool water to relieve dryness and itching.
-- Dr. Donya
Dear Dr. Donya,
I am a 36 years old with diabetes. My fasting sugar level is 180 mg/dl. It has been constant since November 2000. Every morning, I take medication to control my sugar level. Recently, I began to feel weak with little strength in my legs. So I started taking high doses of an antistress drug daily. It worked and I felt energetic and strong. Within 15 days after taking this tablet, I gained three kilograms. At present my weight is 83 kg (height 176 cm).
Ketone in my blood is normal (5.1) while it is negative in my urine. Glucose in my urine is positive.
My father suffered from type I diabetes. He took insulin everyday to control his blood sugar level.
I would like to know the following: Which type of diabetes am I suffering from? What is the optimum level of sugar in the blood to avoid hyperglycemia complications? What is a minimum sugar level for one who is hyperglycemic? And what about my six-year- old son?
-- Satish
Dear Satish,
From your information, I think you may have type II diabetes. There is no definite tests to differentiate type I and type II diabetes. In your case, I think you have type II because you are over 30 years old, overweight (BMI
In type I diabetes, the sufferer develops diabetes before the age of 30, has typically a lean body, requires insulin treatment from the beginning and develops ketoacidosis. In type I, the symptoms are sometimes mild. In the beginning, the use of an oral hypoglycemic drug is practical for adults with type I diabetes. However when he or she uses oral medication for one to two years, it will start becoming difficult to control the sugar level in the blood as the oral medication will cease being effective. It is then time to use insulin shots.
You are overweight and developed diabetes after the age of 30. You should check your blood pressure and lipids -- such as cholesterol and triglyceride -- because hypertension and hyperlipidemia are commonly associated problems in type II diabetes. YOur optimum range should be: * fasting blood sugar -- 80-140 mg/d * blood pressure -- less than 130/85 mmHg * cholesterol, especially low density lipoprotein (LDL) -- less than 130 mg/dL * triglyceride -- less than 200 mg/dL
Your blood sugar level has been at 180 mg/dL for almost eight months. This tells me you don't have good control over your blood sugar level. Exercise, a controlled diet or increasing your diabetes medication from half a tablet to one tablet a day might help you maintain your blood sugar level within the optimum range.
As for your son, if you and your father have diabetes, he is at a greater risk of developing the disease. For type I diabetes, there is no prevention. For type II diabetes can be prevented by eating healthily, exercising and avoiding becoming overweight. See if your son is showing symptoms of hyperglycemia and if you suspect so, take him to see a doctor and check his blood sugar level.
-- Dr. Donya