Published: August 10, 2006 08:51 pm         

The rashes of summer

EDMOND — Children see their pediatrician year-round with rashes but summertime brings an entirely new set of irritated skin with an increase in sweat and moisture. Here are some of the more common problems we see this time of year.

Tinea pedis, or more commonly athlete’s foot, is not just for athletes. It is caused by a fungus that thrives in warm, moist environments such as sweaty feet, shoes, public shower floors, locker rooms and pools. Classic signs and symptoms include itchy, burning feet with peeling and scaliness to the soles of the feet and between the toes, especially the fourth and fifth digits.

This is typically treated with over-the-counter antifungal creams such as clotrimazole (Lotrimin), miconazole (Monistat) or tolnafte (Tinactin, Desenex). These preparations come in cream, powder, spray and liquid forms. They must be used for four to six weeks to completely clear the infection.

Feet should be kept as dry as possible and shoes — especially athletic shoes — should be aired out as much as possible. Powder preparations are helpful to apply to the feet as well as inside socks and shoes.

Deep cracks in feet may need prescription medicines and should be observed closely for signs of

infection.

Similar to athlete’s foot is tinea cruris, or “jock itch,” also a fungus, that infects the groin area and upper thighs. Again, you don’t have to be a jock to have the itch! This can occur in boys and girls. This is seen from athletics where moisture is trapped in this area as well as from prolonged exposure to wet swimsuits.

Redness, itching and burning are the hallmarks and again antifungal creams promote healing and relief of symptoms. Preventive measures include keeping these areas dry, using clean towels, changing underwear daily and washing athletic supporters daily.

We are seeing rashes from exposure to hot tubs more frequently. “Hot tub” or Pseudomonas folliculitis is caused by bacteria that live in unchlorinated whirlpools. The bacteria enters the hair follicles and causes itchy red bumps and pustules one to four days after exposure. The rash may be worse under swimsuit areas where contaminated water has had longer contact with the skin.

Treatment consists of cleansing thoroughly with soap and water and applying antibiotic ointment. Itching can be controlled with antihistamines, such as Benadryl, to prevent scratching and further spreading. Occasionally, an oral antibiotic may be needed. This is a contagious rash and infected persons should not use a hot tub until the rash is completely cured.

Finally, there is an alarming increase in staph skin infections. Of greatest concern are those from MRSA or methicillin-resistant Staphylococcus aureus. This bacteria used to be seen and contracted only by patients in the hospital setting, but children and adolescents are now commonly exposed in the community setting.

This can be seen any time of year and is common among young athletes.

The infection can be transmitted from skin-to-skin contact but also can be carried in the nasal passages of a person. Usually there is a single tender lesion that rapidly becomes a pustule or abscess with surrounding redness and is warm to the touch.

This type of lesion should be seen by a physician, often to be drained and cultured. Treatment may include cleansing with antibacterial agents, antibiotic creams and oral

antibiotics.

Most of the rashes seen are unpleasant but usually not too serious and often preventable. When fever, signs of illness or significant pain or swelling is associated with a rash it is best to see your doctor.

(Dr. Denise C. Scott is a practicing pediatrician in Oklahoma City with The Pediatric Group.)

     

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