Contact Dermatitis

What I really wanted to title this post is - I Flipping Hate Catch-All Diagnoses That Doctors Use When They Don't Know What the Eff is Wrong

WebMD simply states the following about contact dermatitis:

You call it a rash. Your doctor calls it dermatitis. Either way, it happens when your skin gets inflamed after it comes in contact with something.

W has had a rash now for almost a month.  It started on his left thigh.  Traveled down his leg.  At this point we brought him to the Immediate Care Clinic on base.  The doctor there diagnosed it as ::insert some Latin sounding word here:: and prescribed him a cream and Benadryl, said it should clear up within a few days.

A few days pass, it spreads to his other leg.  I try to get an appointment with his pediatrician but the Central Appointment Line says there's nothing available in peds for 10 days!  So I call the pediatrician clinic directly and they say to bring him in, they'll have a nurse check him out and squeeze him in with one of the doctors.  We were there for 3 hours during which two nurses and two doctors spent a ton of time staring at my son and flipping through a book of skin ailments trying to figure out what the heck is going on.  They settle on contact dermatitis.

Contact dermatitis is a diagnosis they use when they can't come up with a real diagnosis.  They don't know what caused it.  They don't really know how to fix it.  But they can't just say that, so they call it contact dermatitis.  I hate stupid catch-all diagnoses!!!

They prescribe him more cream (this time hydro-cortisone) and a different antihistamine.  I insist on scheduling a follow up appointment for four days later (they, once again, claimed it should clear up within a few days).

It then spreads to his shoulders and arm pits.  This is what my poor baby looked like at his worst:

Arm Pit

Upper Arm

Other arm

Calf

 I couldn't get a decent picture of his thigh because he was squirming so much, it actually looked more like his arm pit (the first picture).

Thigh

top of legs

Those pictures really don't do it justice.  His legs were bright red.  His left thigh didn't have any normal looking skin left.  Any time he would step on the grass his legs and ankles would actually swell up.  The stuff on his arms and shoulders wasn't really red, just bumps everywhere (except for his arm pit, that was bright red as well).

When I went to the follow up appointment the doctor simply put there was nothing more they could do.  They would have to refer us to a dermatologist so that they could prescribe a stronger steroid ointment to use on him.  That appointment ended up being scheduled for next Monday (the 24th).

I hate the idea of using a stronger steroid on my son.  There have been studies that show that long term use of topical steroids in children can actually cause growth delays.  Not to mention extended use of steroids are known to cause the following in people of all ages:

Thinning and discoloration of the skin, easy bruising, permanent dilation of certain blood vessels, burn marks on skin, itchiness, perioral dermatitis, liver and kidney damage and a weakened immune system. Recent studies further reveal changes in the shape or location of body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems and impotence. Not only this, but steroid use almost always produces a "rebound effect" of the very symptoms you are trying to get rid of!
Studies have shown that if more than 500g of hydrocortisone (in hydrocortisone cream) is used per week, sufficient steroid may be absorbed through the skin to result in adrenal gland suppression and/or eventually Cushing's syndrome.

From skin-remedies.com

I have no idea what the dermatologist will say, but my gut instinct says that it is an environmental issue.  We live in Lemoore (not by choice, it is where The Sailor was sent by The Navy).  Lemoore happens to be surrounded by basically all the cities that most recently made the EPA's list of the dirtiest (in regards to air and water quality) in America.

1. Fresno, CA
2. Bakersfield, CA
5. Modesto, CA
6. Riverside, CA
8. San Jose, CA
9. Stockton, CA
12. Sacramento, CA
17. Los Angeles, CA

Source

I circled the cities that surround us that made the top 20; we are located under the purple star.

I think a mixture of the extreme heat, the pesticides that are regularly circulating through the air from the farms that literally surround the base, and the poor air and water quality are making my son break out.

Over the past week the rash has improved.  But, over the past week the weather has been much more mild (in the 80's rather than the 100-110's) and I haven't brought him outside to play at all except for brief times out on our patio.  My son cannot be expected to stay inside until we get new orders next summer!  If the rash is being caused by local environmental factors, odds are I will have to get a "note" from the dermatologist and fight the higher ups in The Sailor's command to get new orders.  I will not risk my son being scarred from such a deep and wide spread rash.

Hopefully the dermatologist has a better idea of what's going on.  Honestly, as much as we hate it here in Lemoore (it literally smells like cow shit all.the.time) and we would love a reason to peace out sooner rather than later, I just want my son to get better.  I hate that there's nothing I can do to help him.

Have you ever dealt with doctors trying to give your child a catch-all diagnoses?  Any guesses as to what's wrong with poor little W?