Friday, July 5, 2013

Erythema Multiforme: what every mother should know

If something doesn't seem right , then it probably isn't. 

We are not newbies to rashes. Bryce has had an amoxicillin rash and a fever rash (Roseola) just within the past few months.  He used to get a rash from the carpet when he used to army crawl on his belly. I knew this rash was different. 

Dr:I think your son has erythema multiforme but I'm not completely sure.

Me: what? 

Dr: erythema multiforme. 

What I heard "I think your son has polywollydoodlealltheday" 

Me: what is that? 

Dr: well we don't really know a lot about it. It can be triggered by several different things. It's probably going to get worse before it gets better. It may blister and seep. He may also bruise around his diaper.  It is also a precursor to Steven Johnson's Syndrome...

What im thinking: What the hell is that? It sounds bad. It is a "syndrome" for goodness sake. Wait the dr is still talking...

Dr:... If he gets any in his mouth, on his lips, around it in his eyes do not call here or bother coming up here. You take him to the ER at Children's Hospital immediately. Has he taken any medicine recently? 

Me: yes he is currently on amoxicillin 

Dr: discontinue that immediately and never give it to ever again. He might be having an allergic reaction to it. 

Me: what did you say it was called again?

Dr: supercalifragilisticexpialidosis

What I'm thinking: Right. Dont be an idiot and ask her again

Me: what did you say caused it again? 

Dr: it could be the amoxicillin or it could be viral. The herpes simplex virus is know to cause it. If HSV caused it, he might get this again multiple times throughout life in times of illness. 

What I'm thinking: wait, what? He can get it again! Herpes? What is she talking about????

Dr: it will probably last up to 2 weeks before it goes away and all we can is give him Benadryl for the itchiness. Again, if any come up anywhere in or around his mouth or eyes take him to the hospital immediately. 

What I'm thinking: this is not what I wanted to hear. I wanted you to tell me it was a heat rash so I could sleep with ease tonight. And your not even sure it is "polymitoitisdosis" or whatever the hell you called it. 

We leave and head to Walgreens for Benadryl. My mind is going in circles. What did she call it again? You can't really google "pollywollydoodlealltheday" so I googled the one thing I did remember her saying. Steven Johnson's.

I do not advise anyone doing a google image search for Steven Johnson's because I almost threwup. Basically your skin blisters and falls off, including your lips and eyelids. It has a very high fatality rate. Survivors are left blind and their skin forever deformed. 

I freaked out. She didn't say SJs was what he had but i did remember her specifically saying what she thought he had was linked. 

Just moments before I had wished it wasnt chicken pox. How ignorant of me. Now my head was filled with visions of Bryce's skin falling off. 

I spent the next 48 hours walking around thinking "But there aren't any in his mouth. There aren't any in his mouth. There aren't any in his mouth. Maybe I should go check his mouth."

Meanwhile his spots were getting more red and bigger and spreading further all over his body. 

I was trying my best to keep my cool. If only I could remember what the dr called it! But then again she didn't seem so convinced herself. So I spent some time online looking at pictures I all sorts of rashes. I was so perplexed. None of them looked anything like his. I even found a multitude of slideshows of "common childhood rashes" that included everything from scarlet fever to heat rash. Still, none of them looked like his.  

I was frustrated. So I put the pics of his rash on Facebook and waited to see what people thought. It was actually one of Scott's friends who is in med school that started asking all sorts of questions and finally told me his educated guess was Erythema Multiforme. 

When I googled Erythema Multiforme I immediately felt some relief. His rash, while much much milder, looked identical  to the pictures online. Everything I read about EM matched what the pediatrician had said. All of his symptoms fit. 

It was clear that Bryce had EM minor and would probably not need any treatment and it would clear up on its own. Apparently the minor form is much more common than the major form which leads to hospitalization and sometimes Steven Johnson's. 

By Friday morning the redness had faded and his spots were more flat than raised! It was a huge sigh if relief!  

So my message is this- 

If something doesn't seem right it probably isn't. 

If your child ever gets a rash and blisters pop up in his/her mouth,eyes, or other mucus membranes take them to get seen immediately. It could be harmless Hand Foot Mouth but it could be much more serious. 

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