Ask an Expert: raised red rash with central clearing

Skin Care and Diseases

raised red rash with central clearing
07/21/2005

Question:

My 2 1/2 year old daughter has had a transient rash for the past 4 months. Each oval lesion is about 1.5 cm, red and raised with a central clearing. They only occur on her back. The most she has ever had at one time, is 2 lesions and they usually fade by 4 days. They are itchy. She is otherwise healthy. Thank you in advance.

Answer:

The story that your daughter's lesions "come, change in texture, clear centrally, fade, and then recur" might fit with the diagnosis of erythema chronica migrans. I am concerned about that diagnosis since lyme disease can be associated with it.

Urticarial lesions, urticarial vasculitis could be considered. Very clearly your daughter needs to be seen by a board certified dermatologist and an accurate evaluation made of the lesions. It is hard to second guess the issue.

Good luck!

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Response by:

Charles L Heaton, MD
Professor
College of Medicine
University of Cincinnati