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Have itchy red bumps on legs, no respiratory problem. Had shingles. What could it be?

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Practicing since : 2006
Answered : 2016 Questions
70 year old Native American male, located in XXXXXXX Nevada Foothills has spotty red bumps bilateral legs. Had shingles for 90 days a few months ago. Has been digging out basement and exposed to red, clay dirt. No respiratory problems except for occasional cough r/t dust while digging. This leg rash has lasted over a month, is very itchy, disappears sometimes, has clusters of bumps and also widely spread out individual bumps. Valley Fever is not in our area . . . doesn't look like poison oak . . . doesn't hurt like Shingles . . . Not on any medications . . . no changes in diet, laundry detergent, etc. I am baffled!
Posted Sun, 15 Sep 2013 in Skin Hair and Nails
Answered by Dr. Kalpana Pathak 2 hours later
Brief Answer:
It is definitely not shingles

Detailed Answer:
Thanks for writing to us.
Shingles or herpes zoster is a viral infection presenting itself as clustered fluid filled lesions affecting a particular segment of body. It usually occurs just once imparting lifetime immunity. As your lesions are bilateral and you already had shingles, so these lesions are definitely not shingles.

The probable cause in your case could be eczematous, insect bite induced hypersensitivity, prurigo lesions, allergic dermatitis, itchy variant of pigmented purpuric dermatosis, psoriasis, lichen planus etc.

I would advise you to upload an image of affected area as it would help me in thinking about a plausible diagnosis. In the meanwhile you may take tablet cetirizine and apply calamine lotion to soothe the area.
Hoping to hear from you soon.
Take care
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