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Dr. Andrew Rynne

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How can an itchy red rash on the body be treated?

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Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 8103 Questions

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Posted on Thu, 19 Apr 2018 in Skin Rash
Question: I have red rash over more than half my body, it itches and burns. My feet and legs are swollen to almost twice their normal size. My hands crack- the skin - and peel. Since XXXXXXX they have probably peeled 6 or 7 times. I'm having cold sweats and chills so bad I have spilled my coffee. Help!
doctor
Answered by Dr. Kakkar S. 44 minutes later
Brief Answer:
Regarding widespread erythema and exfoliation

Detailed Answer:
Hello. thank you.
I am Dr. kakkar (Dermatologist and Venerelogist).
I have noted your concern.
Perhaps you have Erthroderma - exfoliative dermatitis involving near total body surface area.
I suggest you to use a bland moisturizer e.g petrolatum / liquid paraffin lotion, twice or thrice daily.
You may also take an oral antihistamine e.g cetrizine 10mg once daily for symptomatic relief from itching.
Stay in a comfortable environment- not too cold and not too hot as your ski. is compromised and cannot regulate body temperature. I suggest you to take adequate amount of fluids to compensate for increased insensible fluid losses from compromised skin so as to maintain body fluid balance, however, consume less of salt as swelling in legs could be due to salt retention. You should also consume more of proteins in your diet like egg whites, meat, non veg food.
I request you to kindly upload a few images of the affected skin / rash in "Reports Section" so that I am able to guide you better.
Is the scalp also involved? with scaling and redness?
Widespread erythema / erythroderma with exfoliation (including involvement of palms and soles) can be due to several causes like Psoriasis, Atopic Dermatitis, Contact Allergic Dermatitis, Pityriasis rubra pilaris, mycosis fungoides/ cutaneous lymphoma etc.
You might require a skin biopsy to ascertain the exact cause of widespread erythema.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. 13 minutes later
My Dr. has me using a once a day antihistamine, 180mg. I have tried every bland moisturizer I can find, and must use them several times an hour, plus wearing plastic gloves to prevent skin cracking. I don't know if the scalp is involved. So far there is no rash on my face, so perhaps the scalp is still clear. I have had 5 skin biopsies done and no answers. Is there anything I can do for the pain in my feet?

What can I do for the itching? Cortisone creams and steroids don't do any good.
doctor
Answered by Dr. Kakkar S. 1 hour later
Brief Answer:
Regarding widespread erythema and exfoliation

Detailed Answer:
hi.

Pain is likely due to the cracking of skin /fissuring of skin of hands and feet. I suggest you to use the moisturizer as frequently as possible. You must also use a potent topical steroid ointment e.g clobetasol propionate 0.05% ointment, twice daily, for the painful cracks. In addition to that, Oral acitretin might prove to be very useful in cracked skin of hands and feet.
If the cracks are infected and oozing then that may be the cause of pain. In that case I would recommend a course of an oral antibiotics.
For itching I would recommend adding another oral antihistamine e.g tab. cetrizine 10mg once every night in addition to the 180mg of fexofenadine that you are already taking.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. 1 hour later
Thank you for answering my questions. I have used two 45gram tubes of betamethasone dipropionate ointment usp, 0.05% which did nothing but make the itching worse and spread the rash. I know this all sounds wrong, but this is what I've been dealing with since early XXXXXXX My own doctor seems stumped. I've been to a dermatologist, and she was no help. Thanks for trying to help.
doctor
Answered by Dr. Kakkar S. 5 hours later
Brief Answer:
You are welcome

Detailed Answer:
thank you.

For such a widespread erythema and peeling you definitely need a specific oral treatment e.g an immunosuppressives like Methotrexate or Cyclosporine if the underlying cause is suspected to be either Psoriasis or Atopic Dermatitis. Topical treatment alone either won't help much or would show slow improvement. If you could have uploaded a few images of the affected skin in "Reports Section" may be I would have had a better idea about the possible diagnosis.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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