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Archive for the ‘Dermatology’ Category

Colorful….

Mom frantic, phoning about her little 2 year old boy (why am I not surprised!):

Mom:  My little boy has colored with non-toxic markers all over his body.  He even marked up his penis, under the foreskin.

Me: Well, you are lucky it’s non-toxic!

Mom: How do I wash it off without hurting him?

Me: Why bother washing it off? Just leave it.  I am sure he will get plenty of baths and it will eventually come off!

 

(And I am sure no one is going to see it anyway…….)

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Rash.

Young adult wants to go to ED to have his armpit rash looked at.

CALLER:  I just got out of the hot tub and now I have a rash under my armpit.  It’s a little itchy….

ME: Any breathing problems to go along with that?

CALLER: Nope. Just the rash.

ME: Is the rash anywhere else???

CALLER: Nope. Just in my pits….

ME: Have you tried home treatment? In other words – a cool pack, an antihistamine, calamine lotion, OTC hydrocortisone cream….anything????

CALLER: Nope – that’s why I want to go to ED!!!!

ME: Ummm….sounds like you could use some HOME TREATMENT…. “Home” meaning – YOUR house, not the ED….

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Screaming kid

Mom has had her 4 year old to the Clinic, had rash ID’d and was told to treat symptoms at home:

CALLER: I have a screaming kid here, what can I do? Her rash is really bothering her.

ME: Did your MD prescribe any cortisone cream?

CALLER: Yes, but my daughter won’t let me put it on her.

ME: Have you tried an oatmeal bath?

CALLER: She doesn’t want to go in the bath.

ME: Have you tried benadryl (or whatever was rx’d)?

CALLER: She won’t take any pills.

ME: How about cool cloths on her skin…?

CALLER: SHE DOESN’T LIKE THAT!!!!!

ME:  Ma’am. I am trying to help you here…..

CALLER: YOU SHOULD BE ABLE TO TELL ME WHAT TO DO!!!!!!!

ME: I have been…..

CALLER: YOU KEEP TELLING ME TO DO STUFF SHE DOESN’T WANT TO DO!!!!

ME: Who is the parent here?   Sometimes there are things a child wants to do but you wouldn’t let her because it’s dangerous….do you stop her or let her go ahead?  Same thing.

Once again, I don’t have that magic wand……………..

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Distraught mother phoning about her 2-year-old (highly edited):

CALLER: my baby has hives ALL OVER HER BODY!!!! We are just getting ready to go to ED!!!!

ME: They usually don’t like to see RASHES land on the doorstep of EDs or Clinics unannounced….is she breathing OK?

CALLER: OF COURSE SHE IS!!! It’s this rash all over her body!!!!

ME: So they are all over her neck and face ?

CALLER: No….

ME: …all over her back and chest?

CALLER: No….

ME: …all over her legs???

CALLER: No…

ME: …all over her arms????

CALLER: No….

ME: Well, that’s pretty much all the body parts….

CALLER: there is one spot on her hip and three on her knees and one by her ear……

ME: Do they bother her?

CALLER: No

ME: Does she have a fever?

CALLER: No

ME: any swelling or open areas?

CALLER: No.

ME: I believe you would be safe to stay home and just keep an eye on it…….

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ME: how can I help you?

CALLER: I have five bites on my neck. I can’t see them. Can you tell me what bit me?

ME: Ummmm.   You know that we are on the phone and I can’t see you, right?

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Rash

Me, trying to determine what a client’s child’s rash looks like. Mom has already diagnosed Chickenpox:

ME: Does it look bumpy with clear pustules?

CALLER: No……

ME: Does it look like hives?

CALLER: Well it sort of does…..

ME: Does it have red around the edges, paler in the center and varying sizes?

CALLER: I think so…..

ME: or maybe does it look like blood spots or bruises – broken blood vessels under the skin?

CALLER: Ya, maybe that…..

ME: Or like a sunburn?

CALLER: Ya I think maybe…..

ME: Look, it can’t look like ALL of those things….which one does it look like????????????

*the sound of me poking my eye out with a sharp pencil*

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