skin rash concerns and skin irritation
Hello everyone, I need some guidance regarding a troubling skin condition I’ve been experiencing. About a week ago, I began to notice small, itchy bumps that initially emerged on my feet. These bumps were tiny, flesh-colored, and hardly noticeable, yet they itched intensely. Since then, the rash has spread to various parts of my body, including my legs, the insides of my arms, my hands, stomach (where an existing scar has become particularly itchy), and my armpits. Most recently, I’ve found that my lower back has also become very itchy. The situation has deteriorated, with the bumps becoming more pronounced and red in color, and some are even turning white. The areas most affected include the folds of my arms, behind my knees, my armpits, and anywhere my skin rubs against itself or clothing. For context, I visited the seaside on July 2nd and spent time tanning on the beach while using SPF sunscreen and an older tanning oil from the previous year. I did suffer a bit from sunburn initially, took a break from the sun for a day, then tanned again on July 4th without further sunburn. I first observed these bumps on July 6th; since then, I have been careful to stay out of direct sunlight while still applying SPF. Additionally, I purchased some new clothing that I did not wash before wearing, which might be relevant. In terms of remedies, I’ve experimented with taking 20 mg of bilastine, although I’m unsure of its effectiveness. Aloe vera and Fenistil gel (containing dimetindene maleate) have offered some relief, but I also took 10 mg of cetirizine last night without much certainty about its impact. Alongside this, I applied hydrocortisone cream, which has helped alleviate the itching, but the redness persists. I avoid hot showers, haven’t been exposed to sunlight since the rash began, and I’ve avoided sweating and further sunburn, yet the rash continues to worsen, affecting my ability to sleep comfortably at night. I would really appreciate any advice or insights you may have on this matter. About me: - Gender: Female - Age: 22 years - Height: 175 cm (5’8") - Weight: 69 kg (150 lbs) - Medications: Discontinued accutane (10 mg daily) at the end of June - Smoking: Non-smoker - Medical history: Had a benign teratoma ovarium accompanied by gliomatosis peritonei a decade ago, but I am currently in good health. - Duration of the rash: Since July 6 until now.
Answers (1)
7/16/2025, 2:11:01 PM
OpenHealth AI
It sounds like you are experiencing a distressing skin condition with itchy bumps that have spread and irritated various areas of your body. These symptoms can be quite uncomfortable, especially when they affect your daily life and sleep. Let’s break this down and explore some actionable steps you can take.
Main Points
- Your rash's spread and characteristics suggest it could be an allergic reaction, irritant dermatitis, or possibly another skin condition exacerbated by recent sun exposure and new clothing.
- Immediate attention to skin care and potential triggers is crucial for relief.
Explanation
The itchy, spreading bumps you describe, along with their appearance and location, may indicate that your skin is reacting to something, which could be related to:
- An allergic reaction to new clothing or products (including sunscreen).
- Irritation from sun exposure, even with SPF protection.
- Potential contact dermatitis or conditions like eczema or hives.
Given that the rash worsened within a week of sun exposure and using new products, it's essential to consider possible allergens or irritants.
Actionable Next Steps
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Stop Using Potential Irritants: Temporarily discontinue using everything new you have recently applied, including the tanning oil, new clothing, and any potentially irritating lotions. Stick to gentle, fragrance-free products.
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Apply Cool Compresses: To help soothe the itching and reduce inflammation, apply cool, damp cloths to the affected areas for about 15-20 minutes several times a day.
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Continue Anti-Itching Treatments: Since hydrocortisone cream has provided some relief, continue using it on affected areas, applying it sparingly to not exacerbate irritation. You might also benefit from an oral antihistamine (like cetirizine), taken before bedtime to help with sleep if itching disrupts it.
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Moisturize Regularly: Use a fragrance-free, soothing moisturizer to hydrate the skin and reduce irritation, especially after any washing or bathing.
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Observe Your Skin's Reaction: Keep track of any changes in your rash’s appearance, and note any new symptoms that develop. This can be helpful in identifying specific triggers.
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Monitor for Severity: If the rash shows no signs of improvement in the next few days or if you notice worsening symptoms (e.g., swelling, pain, or fever), consider seeking professional medical advice for further evaluation and treatment options.
Reassurance
It’s understandable to feel anxious about a rash that keeps worsening. With the proper approach, many skin conditions improve over time, especially when potential irritants are removed. Prioritizing gentle skin care and avoiding known triggers is key. If you would like more detailed information about any suggestions or if symptoms escalate, please reach out for further guidance.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - **Portocaval shunt size: 9.9 mm** (blood bypassing the liver into the inferior vena cava) - **Arteriovenous shunt size: 4.4 mm** - **Portal vein size: 6.1 mm** (patent) - **Three nodular cystic lesions** located in the perivascular area, with largest measuring 11.6×20.7 mm, enhancing during the venous phase - Liver features a heterogeneous architecture, exhibiting irregular enhancement - Gallbladder appears elongated and slightly enlarged - Other abdominal organs exhibit normal findings **RADIOLOGIST’S ASSESSMENT:** "Congenital portosystemic shunt indicative of Abernethy malformation; less likely arteriovenous malformation (AVM); cannot dismiss the possibility of localized liver lesions." **ADVICE:** Seek consultations with an abdominal and vascular surgeon. ### Blood Tests (August 1, 2025): **Complete Blood Count:** - WBC: 10.44 × 10⁹/L (normal range) - **RBC: 2.1 × 10¹²/L** (LOW - indicating severe anemia) - **Hemoglobin: 69 g/L** (CRITICALLY LOW; normal is 117-166) - Platelets: 403 × 10⁹/L (elevated) **Biochemistry Analysis:** - 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WBC: 5.8 × 10⁹/L (SHOWS IMPROVEMENT) - **RBC: 2.93 × 10¹²/L** (IMPROVED but still low) - **Hemoglobin: 72 g/L** (SHOWS IMPROVEMENT but still low) - Platelets: 223 × 10⁹/L (BACK TO NORMAL) - Neutrophils: 30.0% - Lymphocytes: 64.8% - Monocytes: 4.6% ### Biochemistry (January 28, 2026): - Total protein level: 67 g/L (slightly deficient) - Creatinine: 20.7 μmol/L - **Total Bilirubin: 242 μmol/L** (STILL HIGH - unchanged) - **Direct Bilirubin: 142 μmol/L** (VERY HIGH) - **ALT: 50 IU/mL** (DRASTICALLY LOWER from >1000!) --- ## OVERVIEW OF PROGRESS OVER 6 MONTHS | Parameter | August 2025 | January 2026 | Change | |------------------|-------------|---------------|--------------------------| | **Hemoglobin** | 69 g/L | 72 g/L | ↗ Slight improvement | | **RBC** | 2.1 | 2.93 | ↗ Improved | | **ALT** | >1000 | 50 | ✓✓ MAJOR IMPROVEMENT | | **Bilirubin** | 245 | 242 | → Unchanged (still elevated) | | **Portal vein** | 6.1 mm | 3.9 mm (US) | ↗ Decreased | | **Platelets** | 403 | 223 | ↘ Normalized | | **Shunt size** | 9.9 mm | 9.9 mm | → No Change | --- ## CURRENT SITUATION (February 2026 - 7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - 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Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? 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