Cough Variant Asthma? Help

Hello, I have never done this before, so I hope it helps. maybe if enough people can put their heads together, we can come up with something. I have a Bachelor's Degree of Health Sciences as well as a Licensed EMT in Nebraska in the US. I hope that is ok.

Here is some history:

I have an 11yr. old boy, (soon to be 12yr. in 3 wks.) He weighs 64 Ibs. He is small for his age, normal for my kids, but he is very active. Last May, he started to have a persistent dry cough as well as this weird rash on his chest, abdomen, and back. It does not spread anywhere else. It looks like a fungus. So, we were putting this antifungal cream on it, that just made it mad, the rash became dark bright red and then started to scale. When it scaled it had a white film over the red parts, this then became itchy to him, he scratched, and the white film was like "shedding" off of the red spots, kind of like picking off a scap. The spots are random, there is no cluster, no big patches. they are the size of 1/4 of a dime or smaller in random spots. He does have allergies as well. He had been on Zyrtec 10mg, 1 tab am, Advair HFA 2 puffs am/pm, and Singulair 5 mg. pm, Benadryl at pm before bed. During the span of a year in September of last year the Asthma Allergist had him on 6-7 meds, and he was way over medicated, so I took him to start over at the PCP. All medicines were stopped to basically start over and see what is working and what is not. I agreed, it was nice to have my son back and not a medicine head.

He has a Primary Care Physician as well as an Allergist Immunologist. These are not hives or eczema, my second thought was psoriasis, nope not that wasn't it either. We tried Elecon as well as Desowen, nothing worked. It wasn't staph either. They just look a little darker then his skin tone and like spots, he calls them his polka dots. The cough is a dry cough, and he could not breathe through nose for 7 months. He has been on Erythromycin, Amoxicillin, Z-Pack, and Cefinidir. One of these I cant remeber which one fixed the rash, it was a treatment for A-Typical Bacteria, which also fixed the cough temporarily. He has had a CMP, CBC, and a Pathology Lab, Chest X-Ray, and CT of sinues. All came back normal except the rhino cavity was clogged, so he was put on a new nose spray. Astelin Pro. Which helped him be able to breathe through his nose and helped reduce the drainage therefore reduce the cough. "Reduced" key word, he still has a cough! However, he had a huge relapse in the last month. He was diagnosed with Sinusitis and Bronchitis with an exacerbation of asthma. He is an asthmatic, however he has never had an exacerbation. He has Cough Variant Asthma, which can be disguised as acute bronichitis, d/t no wheezing during exacerbation. He was put on another round of Cefindir 5mL/250mL for 10 days and of course Albuterol 0.83% breathing Treatments as needed for attacks. Today is his last dose of the antibiotic. On Monday, March 24, 2014, he was not able to go 2 hours with out a breathing treatment. So, of course I had to go get him from school. He saw his Asthma & Allergist Immunologist that day, Dr. Rhazdan. She put him on 20mg of Prednisone for 3 days, 10mg of Prednisone for 3 days, and back on the Advair HFA. In May when I took him to be seen at this very same office the Physician Asst. there took him off that inhaler because they said that the FDA no longer manufactured it. So, they put him on the Advair 100/50 Diskus. I advised the PA that he rarely uses an albuterol inhaler/breathing treatment. That in a year span he will only need the albuterol inhaler/breathing treatment a handful of times, and when he does use the albuterol inhaler he uses an aerochamber to assist. Therefore he does not know how to breathe in and use the regular inhaler properly without the aerochamber, how will he be able to take the diskus medicine properly? When he was removed from the Advair HFA to the Diskus is when all this started. Honestly, my guess is that he wasnt able to breathe it in correctly and the powder has guncked up his lungs and bronchioles which is in turn causing inflammation as well as the spots from body's response to bacteria growing on the inside or molded powder.. which he is also allergic to mold, and this is what is causing everything. So, to end my pleading for help, I took him back to Dr. Rhazdan on Monday, and she said that the Advair HFA was not taken off the manufacturer list, and put him back on it as well as some of his other medicines. So, now he on the Prednisone described dosage above, as well as the Zyrtec 10mg, Advair HFA used with aerochamber, Singulair 5mg. He finishes antibiotic today, and he still sounds like crap. I dont know what to do. I guess my next step is to get a referral to a Pulmonologist and a Dermatologist. ?? Suggestions?? Advise??

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