Urticaria Multiforme.

As a parent, you see some weird stuff.  This one though?  Let me preface this by saying, I attempt to remain calm when the kids get sick, but this was so weird, it had me really concerned.   All of the pictures were taken on my cell phone in the course of communication to Dave and my sister about just what the heck this might be.  After we figured out what it was, I thought that other parents might benefit from seeing the weirdness while they are frantically Googling “toddler rash” or “changing rash” or “toddler hives” or “toddler rash after virus” or “WHAT THE HECK IS THIS RASH ON MY TODDLER aaaaahhhhhhh!”  Because two weeks ago, that is what I was doing.

Finn, since he’s in the epicenter of yuck, also known as first grade, came home with a really terrible cold.  He was sick for about 5 days, high fever, bad cough, and chest congestion.  We ran him to the doctor who checked him thoroughly, said it was a bad virus going around, and cleared him to go back to school.  Tate seemed to be totally fine and then a few days later on Sunday night, she started coughing and we were sure that she just had the same thing that Finn did.

Monday morning, she woke up feeling warm and ran a temperature around 101, high, but not super alarming.  I gave her Tylenol and put her in a bath.  She was coughing and in general really miserable.  She was whining and upset most of Monday and didn’t want me to put her down which is odd for her.  I asked Dave if he thought we should take her in and we agreed that she probably just had the same yuck that Finn did and we should wait it out.  Monday evening she coughed so hard that she threw up on Dave.

Tuesday morning, she had a fever of almost 103, again with the bath and this time I went with ibuprofen.  Dave called the pediatrician’s office who told him that even with the fever and cough, as long as she wasn’t wheezing, they wanted us to monitor and let it run it’s course.  Then, a couple hours later, we saw a spots of a weird rash/hives on one arm and one leg.  Dave called again and the pediatrician told us to come in.

 

We weren’t sure if it was an allergic reaction or some crazy disease or what was going on.  {She has had Tylenol and Ibuprofen before and we haven’t changed anything else soap/detergent wise.}  Dave drove her to the appointment and in the fifteen minute drive, her face had broken out with a few hives as well.  The doctor saw her, checked her from top to bottom, did a strep test, and said that she thought it was her body’s reaction to the cold virus and fever.  She told us to give her Benadryl every 6-8 hours and that when the Benadryl wears off, it might make the hives might slightly flair again. 

Dave had to get on a flight for a business trip, so feeling better about what was going on, we drove him to the airport, came home and had dinner, then I put the kids to bed.  Tate woke up around midnight coughing.   Then, she threw up everywhere in her bed.  I gave her a bath, gave her another dose of Tylenol and Benadryl, and put her in bed with me.  When she woke up in the morning, she was covered from head to toe in rash.  It had changed from a just a few red hive-like spots to a full blown mottled red rash. 

This wasn’t the ‘slight’ hive flaring I had imagined… I She didn’t seem to be bothered by it much, it wasn’t itching, and her fever was slightly lower so I continued to keep an eye on her. 

 

By Wednesday evening, the rash had morphed into something a little different and she had a little weirdness around her ankle.  It looked almost like a tiny blood blister under her skin.  I called Lyndsey and asked her to come take a look and she thought that maybe we should go to the ER just to make sure it wasn’t something serious.  We’re lucky enough to have an excellent children’s ER in the city so in we went.  We had such excellent care and a bunch of the resident peds docs came in to take a look at the mysterious rash.  At this point, it was red covering almost everything with white portions of skin showing.   They decided that they wanted to admit her to monitor it for the night since she still had a fever, at that point Dave started looking for flights to come home. 

 

 

In the ER, they did blood tests and urine tests.  The nurses were shocked that she was potty trained and they didn’t have to catheter her.  She whipped her gown off and let the doctors look at her ‘scratch’ {rash} and told everyone about the shot {iv} in her arm.  All of the tests came back ok, they pulled the strep test results from her pediatrician, and at that point, the rash was changing again and now looked like a weird white center that looked like a purple bruise under the skin every so often.  This was, I think the third or fourth time it had changed appearance since it started.

After they spoke to her doctors and the pediatricians upstairs, the ER pediatrician said that we could go home instead of staying as long as we followed up first thing in the morning with her doctor.  All of her test results were in the good range, she was drinking fluids, animated and after four hours in the ER, we headed home to try to sleep.  She was wired and didn’t want to sleep most of the night, but in the morning, the rash was less angry red looking and more like purpley blue hue. 

Dave made it home that morning.  She had another pediatrician appointment that afternoon.  They wanted us to monitor the shape of the rash and notify them immediately if any blisters or sores developed in the hives.  {That could be a sign of erythema multiforme which is a very serious disease and the two can often be confused.}  When we asked, they told us that they could give her a shot of cortisone, but felt concerned that it might mask any of the symptoms she was having which is a bad thing when making sure they were right in their diagnosis.  The hives at this point were itching any time the Benadryl wore off.

Two days later, she had only slight markings left, it kind of reminded me of what a faint birthmark might look like.  It went as quickly as it arrived.  It can last up to ten days, Tate’s lasted five.

Have you ever seen anything like this?