This doesn't address Mary Li's question, but Sheri, it sounds as though Adria gets what Kiet does and what landed him in the hospital with a bacterial infection from scratching. I (and my pediatrician concurs) believe it is acropustulosis. Here is what one adoptive mom who is also an MD wrote on the APV list:
<<I am an adoptive parent of 2 awesome little boys from Vietnam, one of whom has had continual outbreaks from a disease called acropustulosis. I am also a medical doctor, doing research in dermatology, and believe that this disease entity is LARGELY under-diagnosed in internationally adopted kids. My belief is that, while considered "rare," it is actually quite prevalent in the population of internationally adopted pediatric patients.
It often occurs after a scabies infection, and usually manifests as recurrent pustular (blister) outbreaks around the hands and feet in kids under 3 who were previously infested with scabies. These blisters ITCH, crop up in groups, then resolve, and a few weeks or months later, new ones appear just like the previous batch.
I know many AP's have bounced from doctor to doctor trying to get a diagnosis and find an effective treatment for their child's pustular outbreaks. Many of your kids have been treated repeatedly and unnecessarily for scabies infections or other unrelated dermatologic diseases such as hand-foot-mouth, when what they really have could be acropustulosis. While acropustulosis has been written about in dermatology literature, there isn't much that's understood about it and no one has any idea of the incidence. My interest is in highlighting, again, the connection between scabies and acropustulosis and investigating the incidence of acropustulosis in children who had previous scabies infections. Specifically, I am interested in drawing attention to this disease in internationally adopted kids so that it is recognized by pediatricians, family docs, and dermatologists as a common complication of scabies that occurs relatively frequently in immigrant children.>>
Right now Kiet is suffering horribly from it as hot, humid weather really makes it act up. Just thought I'd pass it along because so few US MD's know about it and it may save you from having to be in an isolation ward in the hospital someday while different doctors from different departments dither about what is causing it and then prescribe very potent anti-scabies pills for your entire family.
