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Are skin blemishes on back, neck and rashes on thighs signs of eczema?

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Posted on Thu, 5 May 2016
Question: I am a 38 year old male married. I work in a cold weather area in extreme climate. For last three months i had itching rashes and reddening of skin. My rpts (sugar, cholesterol,thyroid,uric acid,liver function test, cbc and urine) in dec all ok. I was diagnoised as pityriasis folliculi for itching and papules on back and neck by a dermat. After a month on meds my papules have gone and skin blemishes on back on neck. But i have three big red round rashes on my right thighs (lap area). I consulted another dermat he has diagnosied it as eczema.
I am confused what it is
doctor
Answered by Dr. Asmeet Kaur Sawhney (27 minutes later)
Brief Answer:
Upload pictures

Detailed Answer:
Hi
Thanks for being at healthcare magic

I would recommend you to upload the photographs of the rashes so that I can have a clearer picture of the condition and can guide you accordingly whether it is eczema or pityriasis folliculitis.

Regards
Dr Asmeet

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Asmeet Kaur Sawhney (15 hours later)
Pic uploaded. Additional info
1) I work in j&k at a bridging site for past three years. Weather is inclement, water is hard and work is outdoor
2) The current problem started with a itch in the lap area due to thermocot lower. I shaved the area(with own daily razor). The condition aggravated.
3) the skin is in hyper mode for past five months with itching rashes etc
4) earlier no problem. As already informed my tests in dec 15 all ok. I had done all std and hiv tests in 2011 before marriage and no history of any risky behaviour.

my questions
Why skin in hyper mode?
will this be life long?
is current diag and med (droxyl500, fultibact cream, levocitrizine) ok? (will start today)
how to avoid recurring skin conditions as create lot of trouble.
doctor
Answered by Dr. Asmeet Kaur Sawhney (2 hours later)
Brief Answer:
Seems to be ringworm infection

Detailed Answer:
Looking at the picture you have uploaded it seems to be ringworm infection which is a fungal infection.

I would recommend you to send a picture of another rash on the thigh area to confirm the diagnosis.

In such cases I recommend my patients to take oral as well as topical antifungals.

I give them tablet Terbinafine 250 mg once daily along with application of Sertaconazole cream on the affected areas twice daily for 3 weeks.

For itching I suggest them to take tablet levocetrizine 5mg once or twice daily depending on the intensity of itching.

I can't comment on the previous rashes without having a look at them but this rash is due to fungal infection which is making the skin in hyperactive mode.

It is not a life long condition and can be cured by taking antifungal medication.

I don't think you need to apply flutibact cream as it contains steroid and will impair healing of the infection. There is no need to take droxyl which is an antibiotic and has no role in your fungal infection.

Once the condition is cured properly their is usually very less chances of recurrence.

Above answer was peer-reviewed by : Dr. Sonia Raina
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Follow up: Dr. Asmeet Kaur Sawhney (47 minutes later)
I have beclomethasone dipropionate and salicyclic acid ointment and flucanazole tablet ip 150(once a week) given by local paramedic. another pic covering both rashes uploaded. There are small blister non pus in both which burn/pain sensation when touch trouser. Itching jas generally stopped but pain and burn remain.
doctor
Answered by Dr. Asmeet Kaur Sawhney (22 minutes later)
Brief Answer:
Unable to see the picture, kindly upload again

Detailed Answer:
I am unable to see the other picture.
Kindly upload again.
You can take tablet fluconazole 150 mg once weekly but don't use salicylic acid as it will cause irritaion and burning of the affected area and beclomethasone is a steroid which will interfere with healing of the rash.
Above answer was peer-reviewed by : Dr. Sonia Raina
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Follow up: Dr. Asmeet Kaur Sawhney (20 hours later)
I understood the logic behind your diagnosis as anti bacterial will kill helpful bact too and further enhance fungal growth. I got the tab terbinafine and have discontinued salicyclic cream. I didnt find sertaconazole here. Is ring guard otc cream ok?

the blisters are drying up but still red and some are still wet. They create lot of pain/burning sensation while walking (though i use a loose trouser) and the appearance is scary.It doesnt itch but burning sensation when rubs against trouser.
Is liquid filled blisters a normal condition? How long will it (the rash pain and blisters) generally last?

though this is not in your domain, i had to do double payment for a single recharge of 199/- as my banks shows debit but no credit shown by customer care. Standard reply is will revert in two days by the time the question gets closed. So had to recharge double.
doctor
Answered by Dr. Asmeet Kaur Sawhney (48 minutes later)
Brief Answer:
Burning is because of salicylic acid

Detailed Answer:
The burning and redness is because of the salicylic acid you have used as it irritates the skin. It is not a very common finding in ringworm infection.
Don't use ring guard cream. If sertaconazole is not available look for terbinafine cream or clotrimazole cream.
Either of two can be used twice daily on the affected areas.
For burning take tablet levocetrizine 5 mg along with tablet diclofenac 50 mg once daily for 5-7 days till it disappears.
Your symptoms should start improving in 5-7 days but the antifungals are usually continued for atleast 3 weeks.
For GP questions two free follow ups are allowed and I think it has exceeded that but you need to confirm with customer care regarding this.
Above answer was peer-reviewed by : Dr. Deepak
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Follow up: Dr. Asmeet Kaur Sawhney (2 hours later)
Are the blisters because of shaving on the area? I had shaved off the area thinking it to be a hair root infection. They are reducing now but still there. Can clotrimazole powder help?
I had recharged after 3 questions. I had to recharge twice for next three consultations i.e 199+199 for three questions.
Hope to clear it off in next five to seven days as it is hampering my day to day activity.
doctor
Answered by Dr. Asmeet Kaur Sawhney (49 minutes later)
Brief Answer:
Yes use clotrimazole powder

Detailed Answer:
Their are less chances of it being from shaving, more because of the use of salicylic acid.
Yes you can use clotrimazole powder.
The blisters and burning will reduce in 5-7 days but the rashes will take a longer time to settle.
Above answer was peer-reviewed by : Dr. Deepak
doctor
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Follow up: Dr. Asmeet Kaur Sawhney (2 days later)
The blisters have reduced and subdued leaving dark red spots. They are still bit painful especially when rubbed and bit itchy too.Hope to recover soon

My few questions
How to get a smooth soft and non itchy healthy skin in winter without oil so as to avoid fungal overgrowth? OTC products like vaseline/nivea ok? What ingredients to check and what to avoid? (on whole body incl face)
How to clear blackening of skin of face neck etc or dark spots caused due to cold weather/cold dry winds and cold burns. Will ayurvedic products like vicco/haldi XXXXXXX paste etc help and will be safe?
Thanks for your help and counselling.
doctor
Answered by Dr. Asmeet Kaur Sawhney (4 hours later)
Brief Answer:
Details below

Detailed Answer:
Yes you will take few more days to recover but continue the anti fungal medication for at least 3 weeks.
Yes you can use vaseline or nivea. Both are equally good.
These otc moisturising creams are usually good without much side effects. You can use whichever suits you. Don't use medicated products containing steroids or hydroquinone as over the counter preparations.
Ayurvedic products will be safe but I don't know how effective they will be.
For blackening I usually recommend my patients to use a sunscreen in the morning and cream containing kojic acid at night. This is usually continued for 10-12 weeks.

regards
Above answer was peer-reviewed by : Dr. Naveen Kumar
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Follow up: Dr. Asmeet Kaur Sawhney (7 days later)
Hello doc
The rash blisters have dried up but the redness and small bumps are still there (dry pinkish red and few with dried up blood) no itching burning. I had 11 doses of terbinafine 250 one daily and applying anti fungal powder.

How long will it take for that to go?
how long to continue the medication?
I am uploading latest pic.
doctor
Answered by Dr. Asmeet Kaur Sawhney (16 minutes later)
Brief Answer:
Continue terbinafine tablet for another 3 weeks

Detailed Answer:
I think it has become better but it will take 3-4 weeks to resolve.
Continue terbinafine tablet 250 mg for another 3 weeks.
Also apply either Clotrimazole cream or terbinafine cream on the affected areas twice daily.
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Asmeet Kaur Sawhney (2 days later)
Does the medicines have any effect on the blood count like cbc/sugar/cholesterol? I have a upcoming routine med checkup scheduled.
Can after shave lotion be used without fear of any fungal eruptions?
doctor
Answered by Dr. Asmeet Kaur Sawhney (1 hour later)
Brief Answer:
Terbinafine mild effect on liver function tests, after shave can be used

Detailed Answer:
Hello, welcome back to HCM.

Oral Terbinafine might have mild effect on liver function tests but in few individuals only. It doesn't alter CBC, lipid profile and blood sugar levels.

Yes After-shave lotion can be used without having any fear of fungal eruptions.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Dr. Asmeet Kaur Sawhney

Dermatologist

Practicing since :2007

Answered : 4407 Questions

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Are skin blemishes on back, neck and rashes on thighs signs of eczema?

Brief Answer: Upload pictures Detailed Answer: Hi Thanks for being at healthcare magic I would recommend you to upload the photographs of the rashes so that I can have a clearer picture of the condition and can guide you accordingly whether it is eczema or pityriasis folliculitis. Regards Dr Asmeet