What's Going Around: Rashes, swimmer's ear, strep

WellSpan Pediatric Medicine Physicians across the Midstate are seeing a stomach bug, strep throat and asthma exacerbations.

The CVS MinuteClinic in York reports COVID, viral upper respiratory infections and swimmer's ear this week.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics reports swimmer's ear, pink eye, tick bites, strep throat and hand, foot and mouth.

They're also seeing rashes -- including molluscum, ring worm and poison ivy.

Dr. Joan Thode offered the following advice on ring-shaped rashes:

"The three most common rashes that will show up on a child in the shape of a ring are Lyme disease, ring worm and a post-viral rash called erythema multiforme.

Erythema multiforme is differentiated from the other two rashes in that the child usually has many small rings all over their body. These can be flat or slightly raised, and they are more commonly sore rather than itchy. Sometimes they can have a dusky, bruise-like look at their center. This rash typically follows one of several common viruses, and it will go away on its own. In rare cases, this condition can lead to a severe inflammatory response of the eyes, nose, mouth and lips, so parents should watch for severe pink eye or puffy lips in any child with a body-wide ring-shaped rash.

The ring-shaped rash that indicates Lyme is flat and consistently has a clear center. These rings tend to be much larger than those of Erythema multiforme, and there is typically only one ring, circling the tick-bite site. In the next stage of Lyme disease, there may be several simultaneous ring rashes appearing similar to the first ring on various areas of the body. As Lyme disease should be promptly treated, any flat, larger red ring on the skin should be evaluated by a doctor.

Fungal infections of the skin will also form a ring, which is consistently raised with a palpable border. Fungal rashes are universally itchy. Each ring indicates an area of skin with a fungal overgrowth, but it is possible to have multiple rings from multiple individual fungal infections. These rings can be small or large, but they differ from Lyme in that they are raised and itchy. Fungal skin infections are treated with topical anti-fungal creams and will get worse with use of topical steroid creams.

In general, if your child has a ring-shaped rash, it’s a good idea to contact their pediatrician, as they each require specific treatment or close observation."