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Red rash on cheek, no plaques or dryness, itching. What is this spreading rash?

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Practicing since : 2003
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Bright red rash on neck spreading :

Last Monday, I woke up with a small, round red, somewhat dry and scaly patch of skin just below my left cheek on my face-it was on my neck. I had previously treated this area for what I thought was acne, but it was not acne. My dermatologist said the next day it was some type of contact dermatitis and gave me Vanos cream to put on it, which I did. That night I woke up and the whole left side of my neck, down to my chest, was bright red and itchy. I cleaned the area with oatmeal soap and used Vanos on the entire area. When I awakened the next morning, it was not quite as red. I continued to use the Vanos on the entire area, and gradually the initial red patch and the area it had spread to were not as red, although they were still tender to the touch, itchy, and obviously red. Friday night I took a shower, and afterwards the middle of my neck was bright red down to my throat. I put Vanos on it, and it continues to be red, night and day. The initial red patch from almost a week ago is almost back to normal, as is the area below it. None of these rashes have been raised or looked like hives. There are no plaques or dryness. I should mention the creases in my neck are normal skin color. The red areas just look like inflamed red areas. I have started using only fragrance free lotions and changed my detergent to All Free and Clear. I should note that I suffer from severe anxiety and have had many physical conditions caused by this anxiety. Could you tell me what this rash that moves from place to place could be? I am not supposed to see my dermatologist again until Nov. 8th and the itch is driving me nuts. I should also mention the rash feels warm and that I feel hot much of the time, but not feverish. Hot showers make the rash much worse, as does getting hot in my sleep. I am 47 and have had two hot flashes so far.
Posted Tue, 8 May 2012 in Skin Rash
Answered by Dr. Rohit Batra 25 hours later
Going by your history and the localised nature of the rash which is restricted to face and neck it seems most likely that the probable diagnosis is Conact Irritant Dermatitis. In case the irritant causing the rash is coming in contact with the skin in routine , the rash will only get suppressed when the cream is applied but the symptoms will come back as soon as the effect of the drug vanishes.

You have to figure out what is causing the problem, it might be your bed linen, after shave, face wash etc.

In case the culprit is not removed this problem will continue.

Vanos is a moderate steroid cream and is a first line therapy in such cases.

In case the problem persists you might need oral antihistaminics and short course of oral short acting steroids.

You can apply the cream prescribed to you 3-4 times a day for a quick relief. It should not cause any side effects in a short span use.

Hope I have answered your query. Please write back if you have further queries.

Happy Healing.

Dr.Rohit Batra
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