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The Bumps

Greetings from Wales, where I am teaching the last trauma course of the year. I love coming up here and being Dr. Zibners, as you know, but leaving three times in three months has been a fine example of biting off more than you can chew. Next year they already know not to expect me in September. It’s too hard on my family to have me gone so often. And it doesn’t help when I get up here and then receive a call like I did this morning from my husband. Zoe is covered “in a rash.”

A few questions were all I needed to make a diagnosis: red skin, white bumps, “like mosquito bites,” and some had already faded while others were appearing in new places. Hives, I said. Over the course of the day they came and went but Zoe remained completely unbothered by them. Her father sent me a photo of the rash but I didn’t need it to stand my early conclusion; there is no other rash that does what hives do. They come, they go, they move around.
Everyone thinks hives are an allergic reaction but it’s actually more likely they are related to her current runny nose. Most of the time we never learn exactly what caused hives, unless there is an obvious relationship such as “I gave my kid yellow squash and twenty minutes later she had hives.” And even then it might just be viral and a complete coincidence.
So I’ve stayed at my conference. G knows where the antihistamine is and he’s giving her a dose right now. I happen to have an EpiPen Jr in the house (because I’m super uptight) and he’s aware of that too. But most importantly I told him that unless she is having swelling of her lips or tongue or trouble breathing, it’s nothing to worry about. I can hear that he doesn’t believe me, but it’s true. And I told him to expect to see the rash again tomorrow and it’s likely to come and go for a several days. But I’m still expecting a phone call tomorrow telling me exactly what I just said. And when I get home, 100 bucks says my dermatology book is open to “urticaria.” Sometimes it takes a little extra reassurance to quiet an anxious parent.

Dr. Lara Zibners, Nov 11, 2010

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