posted
A couple of days ago my youngest DD (age 13) told me she thought something bit her on the back--it was itchy, etc.
So I took a look at it. A small, (about nickel-size) raised red patch. Hmmmmmm.
I told her I needed to keep an eye on that thing. Of course, she gets all defensive and inSISTS it's not Lyme. (Her older sister has systemic LD and we never saw a rash. Probably has had it 8 years now)
So tonight I looked at it again. Sure enough, it is spreading a little and just inside the outer edge is a little ring of slighter lighter pink.
So off we are tomorrow to the doc. I guess the pediatrician, but I was thinking of trying to get her in to my dermatologist. All I know is, if it is EM the docs won't question me, except for how long to stay on abx. Docs here in MD are strange--they just don't think any of this is a big deal
The fun never ends...
Group Hug
Denise
[ 06. April 2006, 12:45 PM: Message edited by: MomOfLymeTeen ]
Posts: 14 | From MD, USA | Registered: Feb 2005
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shazdancer
Frequent Contributor (1K+ posts)
Member # 1436
posted
Take a good picture of it in sunlight, Mom, so you have the documentation of a rash, even after it fades.
Hope you can get that looked at and your DD treated right away.
Take care, Shaz
Posts: 1558 | From the Berkshires | Registered: Jul 2001
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MagicAcorn
Frequent Contributor (1K+ posts)
Member # 8786
posted
Go to a dermatologist and get a punch biopsy then no one can say anything - ever. Then go to LLMD for treatment once the dermatologist confirms lyme.
Take a ball point pen and make a ring around the rash now. You may be surprised by how much it has expanded by the time you get to the doc's office.
A picture is always good but take it with a regular disposable camera and not a digital camera so you can never be told you doctored it up.
-------------------- Posts: 1279 | From In hiding | Registered: Feb 2006
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WildCondor
Unregistered
posted
Wow, definetly take a picture of it for documentation and make sure that the treatment is carried out for long enough and at the correct doses!!!!
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posted
The dermatologist assured me the rash is ringworm. I would LOVE to believe her, but I refuse to rule out Lyme until I see what this prescription cream does.
She said that it is a typical ringworm lesion, mainly because it is scaly.
She DID give me a lab slip for bloodwork because she saw how concerned I am about Lyme. She said for peace of mind I can go ahead and take her for bloodwork. Of course if I do that I'll do it through Igenix.
Anyway we'll try this cream. I figure if the thing clears up, then the doc is right.
Isn't it a shame that this dreaded disease makes us doubt anything a doctor tells us?
Any advice is welcome.
Denise
Posts: 14 | From MD, USA | Registered: Feb 2005
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MagicAcorn
Frequent Contributor (1K+ posts)
Member # 8786
posted
Did you ask for a biopsy?
-------------------- Posts: 1279 | From In hiding | Registered: Feb 2006
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posted
Be careful of the ringworm diagnosis. I had a round rash following a tick bite(I actually removed a tick)and the doctor swore to me that it was just ringworm! He said it was a classic case!
How wrong he was.........that was 2 years ago and I am still battling this disease. If the cream doesn't work, get another opinion. Hopefully, it is just ringworm. I wish you and your daughter the best!
Posts: 195 | From NJ | Registered: Nov 2003
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quote:Originally posted by MagicAcorn: Did you ask for a biopsy?
No, of course not--I'm an idiot...
DUH I completely forgot. (I think I am catching Lyme-brain from Andrea)
I won't let it go too long if it doesn't clear up. Am I right to assume that if the cream works thn it isn't Lyme? An antifungal wouldn't clear up a Lyme rash, right?
thanks- Denise Posts: 14 | From MD, USA | Registered: Feb 2005
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posted
My LLmd told me that an antifungal will not clear up an EM rash. Sometimes the EM rash will fade on its own without treatment. Mine persisted for over 6 months while I tried antifungals, cortisone and antibiotic creams.
It finally went away after IV antibiotics. By the way, I had a skin biopsy. All it said was that a tick bite could not be ruled out! Not very diagnostic......really wasn't worth the money or effort.
Posts: 195 | From NJ | Registered: Nov 2003
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5dana8
Frequent Contributor (1K+ posts)
Member # 7935
posted
A lyme rash isn't permanate
It shows up and then fades over time .
When you use the cream, will you know for sure
it was the cream/ringworm or the EM rash going away at the same time?
quote:Originally posted by Pitnum: Mine persisted for over 6 months while I tried antifungals, cortisone and antibiotic creams.
After all I've gone through with Andrea for 8 years now, I won't give it more than a couple of weeks if I don't see any improvement.
I am mother, hear me roar
Denise Posts: 14 | From MD, USA | Registered: Feb 2005
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WildCondor
Unregistered
posted
I was thinking the same thing...DID THEY DO A BIOPSY??? Only way to be sure, check the rash. Ringworm is a common misdiagnosis, spider bite too. it may well be ringworm, but nothing is 100%, get it double checked and biopsied!
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posted
I would start ABX right away...time is of essense. The pros clearly outway the cons here. You don't want it to disseminate. Don't wait the two weeks. I'm not a doc, but just my opinion.
Posts: 187 | From Gaithersburg, Maryland | Registered: Feb 2006
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posted
Hope it is ringworm and the cream does the trick.
Derms are not very good at EM rashes, especially atypical ones. A derm at a big name medical institution told me my atypical lyme rash was an actinic keratosis (pre-cancerous lesion) and gave me a cream. Said it would peel off after a month of the cream. When asked what would happen if it was lyme instead (which I suspected), was told nothing would happen...."rash" would remain. BUT IT WAS ABSOLUTELY NOT LYME-RELATED, in their opinion.
Rash remained, cream did nothing. They were wrong.
Posts: 8430 | From Not available | Registered: Oct 2000
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MagicAcorn
Frequent Contributor (1K+ posts)
Member # 8786
posted
A dermatolissit diagnosed my atypical rash and saved me a lot of the heartache many have suffered here. I went from the dermatologist to the LLMD. It saved me the runaround of going to a lot of doctors.
They are the only doctors who can biopsy the rash as a routine test...all any other doctor will do is blood tests. The biopsy does not hurt by the way, it is a little prick closed with one suture, and covered by insurance..
The dermatologist saved me alot of trouble and confusion the way I see it. They didn't treat my lyme...well actually they gave me a prescription for amoxy, and I took that until I could get to a LLMD.
When a rash is present a biopsy from a dermatologist could be a g-d send.
Just my experience here.
-------------------- Posts: 1279 | From In hiding | Registered: Feb 2006
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posted
Wow, I am always impressed when someone comes along with a story like this, acorn. Encourages me that not all docs are doofuses. Need to clone your derm.
The thing I wonder about is that a biopsy sent to the average lab....would you get a false negative in some instances? Are they actually culturing this? When Johns Hopkins did their two year study, they found that biopsy improved the accuracy of a battery of tests, but by itself was also not accurate enough to be diagnostic. Their conclusion is that lyme was a clinical diagnosis, no test good enough. Of course, they still are turning away people with lyme, especially the chronic kind.
My impression is that anyone with an EM should consider biopsy, but don't put complete faith in results.
Posts: 8430 | From Not available | Registered: Oct 2000
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MagicAcorn
Frequent Contributor (1K+ posts)
Member # 8786
posted
A biopsy is definitive proof as far as other doctors, and insurance companies are concerned. That is key to getting proper treatment.
The dermatologist had the resources to culture the sample in her office. I knew my diagnosis at the time of my visit.
All other specialists would base it on a clinical diagnosis, and hope that the blood work backed up that diagnosis.
-------------------- Posts: 1279 | From In hiding | Registered: Feb 2006
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Division of Medical Microbiology, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Lyme disease is usually diagnosed and treated based on clinical manifestations. However, laboratory testing is useful for patients with confusing presentations and for validation of disease in clinical studies.
Although cultivation of Borrelia burgdorferi is definitive, prior investigations have shown that no single test is optimal for Lyme disease diagnosis.
We applied high-volume blood culture, skin biopsy culture, PCR, and serodiagnosis to a cohort of patients with suspected Lyme disease acquired in Maryland and southern Pennsylvania. The study was performed to confirm the relative utility of culture and to identify laboratory testing algorithms that will supplement clinical diagnosis.
Overall, 30 of 86 patients (35%) were culture positive, whereas an additional 15 of 84 (18%) were seropositive only (51% total sero- and culture positive), and PCR on skin biopsy identified 4 additional patients who were neither culture nor seropositive.
Among 49 laboratory test-positive patients, the highest sensitivity (100%) for diagnosis was obtained when culture, skin PCR, and serologic tests were used, although serologic testing with skin PCR was almost as sensitive (92%). Plasma PCR was infrequently positive and provided no additional diagnostic value.
Although culture is definitive and has a relatively high sensitivity, the results required a mean of 3.5 weeks to recovery. The combination of acute-phase serology and skin PCR was 75% sensitive, offering a practical and relatively rapid alternative for confirming clinical impression. The full battery of tests could be useful for patients with confusing clinical signs or for providing strong laboratory support for clinical studies of Lyme disease.
Publication Types:
* Evaluation Studies
PMID: 16207966 [PubMed - indexed for MEDLINE]
Posts: 8430 | From Not available | Registered: Oct 2000
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2roads
Frequent Contributor (1K+ posts)
Member # 4409
posted
Hey there.
I am a mom of 2 kids with Lyme. All illnesses take me to a calender and a concern. However, in January my son got a inflamed circle that sometimes became scaly on his lower thigh. I took him to the doc who is very much aware of my Conneticut respect and affiliation. She diagnosed it as ringworm. I wondered where he gor it from, but then realised he often sat in the shower, and I had something growing on my foot. I put his cream on me too, and together it eventually went away. It takes awhile to dissipate...very stubborn...about two weeks. I too took a picture should anything further pop up. I feel it was "the Worm" not the tick. Sounds like your covering all bases. Mine really itched, his not so badly. Hang in there.
2Roads
Posts: 2214 | From West Chester, PA | Registered: Aug 2003
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2roads
Frequent Contributor (1K+ posts)
Member # 4409
posted
Hey there.
I am a mom of 2 kids with Lyme. All illnesses take me to a calender and a concern. However, in January my son got a inflamed circle that sometimes became scaly on his lower thigh. I took him to the doc who is very much aware of my Conneticut respect and affiliation. She diagnosed it as ringworm. I wondered where he got it from, but then realised he often sat in the shower, and I had something growing on my foot. I put his cream on me toobecause we got the big tube, and together it eventually went away. It takes awhile to dissipate...very stubborn...about two weeks. I too took a picture should anything further pop up. I feel it was "the Worm" not the tick. Sounds like your covering all bases. Mine really itched, his not so badly. Hang in there.
2Roads
Posts: 2214 | From West Chester, PA | Registered: Aug 2003
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