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Suggest Treatment For Spreading Rash On Thighs

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Posted on Tue, 13 Jan 2015
Question:
Hello ive been having this rash that has a mind of its own. It started out in september on my inner thighs dime size spread out like 20 in total on both thighs. Then frw days later it was on my ankles n feet. And twice as many. They were pinkish to red scale bumps who itched like crazy. I went to dr first i was told it was an allergic reaction to sometging then i was told it was scabies then i told it was an allergic reaction to pants. So at this time rash comes n goes. But still itches at nigh so in nov rash gets to behind my knees but dont itch. Then i was told i had psoriasis n given treatment oj tment. Is now three months n i still have the spots im a fair skin type girl n theses spot r ugly n look nasty wat can i do toget rid of
doctor
Answered by Dr. Dr. Kakkar (32 minutes later)
Brief Answer:
I will keep a most likely possibility of Discoid dermatitis

Detailed Answer:
Hello. Thank you for writing to us at healthcaremagic

I have gone through your query and I have also looked at the Image. I have also noted down your symptoms.
In the image I can see red scaly patches on the dorsum of both feet.

I will keep a likely possibility of Discoid dermatitis. Pityriasis Rosea is my second possibility. This does'nt look like psoriasis Or scabies to me.

I would like to know more from you regarding the query.

-Where all is the rash distributed? Does it also involve the torso or arms as well? Is there scalp involvement?
-Has the rash on thigh resolved?
-What medications have you tried till now?

You must use a moisturizer over the whole affected area, twice daily.
I suggest a potent topical steroid e.g clobetasol propionate 0.05% cream, to be applied twice daily, over the patches, over and above the moisturizer. Please check with the local pharmacy if it is available over the counter.
An OTC oral antihistamine e,g cetrizine 10 mg once daily will provide you symptomatic relief from itching.

Regards
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Dr. Kakkar (28 minutes later)
Ive added two pics of all the cream n ointment n pills i have been given. The rash on feet has gone way down when i come after the shower u can see little marks but us not scaly. Now my concern is the rash behind my knees and it goes to buttocks area and the same as feet but mire towards a red color. It looks like a child has taken a red marker and given me spots. Ive used all creams and the second cream i stop using caused it burn too much the last ointment given dors nothing to me. Ive never had any rash ir hives before. This is my first time. I use ceptaphil and aquaphor When this happen i had labs done and im allergic to peanuts which i dont eat, cats/dogs which i knew about and birch/elm/oak tree which is everywhere in new york city. For a fee years now i have develop the butterfly lupus rash on my face but i dont have lupus a mild roseac. I dont use the cream because it burns my face and it dont bither me besides that i never had any skin issue before. On my scalp is normal nothing has change. At first when it did appear i did have the rash on my hands. Top of the hands but with the cream the first one it subsided and now is gone. Rash on thigh is still there. I change detergent and soap bar and change bedsheets 3 times a week. I cant even wear open toes shoes because the rash on feet is visible n is ugly. Please help me .
doctor
Answered by Dr. Dr. Kakkar (1 hour later)
Brief Answer:
I will like to rule out SCLE rash; skin biopsy would be confirmatory

Detailed Answer:
Hi. Thank you for additional information.

The butterfly rash is a significant thing in your history. Whether it is Lupus or Rosacea needs to be appropriately investigated.
It did make me think that this particular rash is of Subacute Lupus Erythematosus (SCLE) which I would like to rule out with your help.

The rash of SCLE is mainly distributed on sun-exposed areas of the body like upper back, upper chest, outer arms, shoulder, dorsum of feet, and top of hands. All these sites are sun exposed. Face is usually spared in SCLE.
Do you have rash on these sites specifically? Let me know.
You told me that you have rash on thighs and behind knee. This distribution of rash is not seen in SCLE as these are sun protected sites. Therefore, it goes against SCLE.
Therefore, possibility of discoid dermatitis is still my possibility.

I would like to know how lupus was ruled out. Were you investigated for lupus and with what all tests? Was ANA test done?
Do you have any history of photosensitvity? Is Excessive redness and burning sensation on face on sun exposure?
Do you have any history of joint pain, Oral ulceration?

With lupus in mind, this rash can also be explained by classic subacute lupus erythematosus (SCLE) rash. It presents as annular or polycyclic rash on sun exposed area of the body but thighs and back of knee involvement is not involved and goes against it.

Clobetasol propionate 0.05% cream, twice daily would be more beneficial in both of these conditions.

However, skin biopsy would be confirmatory in both of these conditions.

Regards

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Dr. Kakkar (6 hours later)
Lupus test was done years back i dont think when my labs were taken test for lupus wasnt done. Lately i been having joint pains more of my ankles n wrist area. I just blame the cold for it. I do get red real fast only on face with the sun n i do have sensitive skin throughout my body more on my face and upper chest area. The rash is not on my arms or elbow nor calf just behind my knee going up towards buttock area and top portion of feet Thank you
doctor
Answered by Dr. Dr. Kakkar (14 hours later)
Brief Answer:
Lupus Erythematosus should be appropriately ruled out

Detailed Answer:
Hi.

In my view SCLE is a possibility and a skin biopsy would be advisable. Blood test for Lupus Erythematosus (LE) is also advisable i.e ANA.
Besdes,other tests like Kidney Function Tests, Complete Hemogram with Total Cell Counts are also advisable.
Joint pains are somewhat suggestive of LE and should not be ignored.
Photosensitivity and malar rash are a significant finding.
Skin rash that you inquired for initially is on dorsum of foot which is a sun exposes site. You also have a history of similar rash on top of hand, which is a sun exposed site too.
So in wake of all the above facts I think LE should be ruled out appropriately before thinking of innocuous diagnosis like discoid dermatitis.
I suggest you to visit a dermatologist for the needful. You may use a broad spectrum sunscreen, throughout the day.

Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

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Suggest Treatment For Spreading Rash On Thighs

Brief Answer: I will keep a most likely possibility of Discoid dermatitis Detailed Answer: Hello. Thank you for writing to us at healthcaremagic I have gone through your query and I have also looked at the Image. I have also noted down your symptoms. In the image I can see red scaly patches on the dorsum of both feet. I will keep a likely possibility of Discoid dermatitis. Pityriasis Rosea is my second possibility. This does'nt look like psoriasis Or scabies to me. I would like to know more from you regarding the query. -Where all is the rash distributed? Does it also involve the torso or arms as well? Is there scalp involvement? -Has the rash on thigh resolved? -What medications have you tried till now? You must use a moisturizer over the whole affected area, twice daily. I suggest a potent topical steroid e.g clobetasol propionate 0.05% cream, to be applied twice daily, over the patches, over and above the moisturizer. Please check with the local pharmacy if it is available over the counter. An OTC oral antihistamine e,g cetrizine 10 mg once daily will provide you symptomatic relief from itching. Regards