24 Week Old With Rash All Over
Brought in by mother for rash that started the day before. Has been having no other sxs. Initially started with small papules on the torso yesterday when it was very hot. Then the papules got a little better last night. Today they weren’t out in direct sun but were outside in 95 degree weather. Mother noted worsening rash that also spread to the face and now on the torso and arms and legs. Some are reddish but most are flesh colored.
No other sxs.
No sick contacts.
Has diffuse fine papules that are flesh colored.
Some papules are reddish especially in the skin creases.
Has no oral lesions.
Normal cardiovascular exam.
Has same rash in the groin area.
No rash on the palms and soles.
The story alone is fairly good for milia rubra. Child looks great. And interestingly grandma told mother that it’s a heat rash and no need to take the child to the doctor… moral of the story is that grandma’s know best! Listen to grandma people. Well except when they crush up a bunch of aspirins and mix it with Vaseline and apply it all over the child’s body… but besides that one grandparents are a fantastic resource for younger parents. I have a good habit of sometimes asking other family members in the room what their impression is or what they think is going.
Diagnosis: milia rubra.
Treatment: less heat exposure.
Confirmed: no, clinical diagnosis.