Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Because children often share many things and are less likely to take
hygienic precautions than adults, parasites and fungal infections can spread
quickly through a day-care center or your child's class at school. Pay attention to any
prolonged itching or hair loss
your child might experience.
Scabies is a very itchy rash that is often worsened with bathing or at night. It
is caused by a mite (Sarcoptes scabiei) that burrows beneath the top layer of skin, where is lives and lays its eggs. It is spread by close bodily contact such as sleeping together or sharing of clothing. It can also be sexually transmitted. Mites can survive for several days in clothes, bedding, and dust. It may take
four to six weeks following initial exposure to develop symptoms.
The itchy rash of scabies tends to be found between the fingers, in the
armpits, and on the inner wrists and arms. It tends to spare the head, palms,
and soles except in infants and with severe infestations. This rash is most bothersome at night. Initially the rash appears as discrete, tiny blisters. After heavy scratching, these areas commonly develop a secondary skin infection. Often only 10-20 mites have burrowed beneath the skin. The large extent of generalized itching represents an allergic type of response to the mite.
Sometimes you can see the wavy pattern under the skin where the mite has burrowed. These are most commonly seen in areas where the skin is most delicate and thin (for
example, webbing between the fingers).
To prevent scabies, good hygiene, frequent hand washing, and not sharing clothing is important. Scabies is purely a person-to-person disease -- animals do not develop scabies.
If your child has an intensely itchy rash that lasts for more than two to three days, he or she
should be checked by a doctor.
Prescription medications are available to kill the mites and to decrease the
allergic skin reactions of swelling and itch. Treatment should occur at the same time for all family members to avoid reinfection. It may take
two to four weeks after the treatment for the itching to subside. If symptoms persist for greater than
four weeks, retreatment may be necessary.
Once anyone in the family is diagnosed with scabies, everyone in the home
should be treated for mite infestation.
All clothing and bedding must be washed in hot water and the mattresses
Ringworm is a local infection of the skin with a
fungus, usually Microsporum canis, Microsporium audouinii, or
Trichophyton tonsurans. Doctors refer to these infections as tinea with
several forms such as tinea corporis (ringworm on the body) and
tinea capitis (ringworm of the scalp). Although the two are caused by the same
organisms, they must be treated differently. Ringworm can be caught from friends
(exchanging combs, brushes, or hats) or from household pets. If you think your
child may have ringworm, you should see your doctor.
With tinea corporis, the lesion starts as a red, slightly scaly oval that
gets bigger over time. As the lesion increases in diameter, the border remains raised, slightly red, and scaly, while the central region resembles unaffected skin. The rash commonly develops
one to two weeks after exposure.
The rash may be slightly itchy.
Tinea capitis usually starts with a round to oval area on the scalp characterized by an associated loss of hair.
Sometimes the area of the scalp will swell and may ooze. This is called a
kerion and is a reaction of the body to the tinea fungus.
Tinea capitis may also present as normal to severe
dandruff without hairless patches on the scalp. It may take six to eight weeks of effective oral therapy to resolve a kerion.
Tinea corporis can easily be treated with topical medications available from
Unfortunately, it can be easily spread among family members and friends.
Good hygiene combined with appropriate therapy can break this cycle.
Tinea capitis requires an oral medication from your doctor.
Athlete's foot is also caused
by a fungal infection of the skin. The medical term for this condition is "tinea pedis."
Athlete's foot is characterized by a very itchy rash between the toes. While it may occur in young children, it is more commonly a disease of older children, teens, and adults. Toddlers and younger children may develop a non-fungal rash between the toes due to excessive dampness of the feet.
Although athlete's foot can be treated with over-the-counter medications,
other causes of rash can appear similar. It is best to have your child checked
by the doctor to confirm the diagnosis if you suspect athlete's foot.
Keeping feet dry and wearing sandals in public showers will help to control the spread of tinea pedis.
A prototypical example of irritant contact dermatitis, diaper dermatitis is caused by overhydration of the skin, maceration, prolonged contact with urine and feces, retained diaper soaps, and topical preparations.