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Dr. Andrew Rynne

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Itchy painful rashes appeared on chest. What is the disease?

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Dr. Sudarshan

Dermatologist

Practicing since :2005

Answered : 1391 Questions

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Posted on Thu, 17 Jan 2013 in Skin Rash
Question: Last week I had an itchy rash on my chest - small red bumps mainly. A couple were larger. It was accompanied by pain in my sternum, particularly on the right side. The visible rash is gone; just scaly skin left behind. But the pain continues, even stronger. Any ideas?
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Answered by Dr. Sudarshan 4 hours later
Hi XXXXXXX,
Thanks for writing in.
The condition you are suffering can be herpes zoster or shingles.

The Rash usually appears suddenly with pain and itching.Can resolve on its own leaving neuralgic pain on one side of the body.It appears in a perticular dermatome.Only one side of the body is affected.Can be very XXXXXXX seated severe pain.
Does this description matches yours?

After resolution of rash if pain continues it is called post herpetic neuralgia.
The treatment consists of stronger analgesics ,neuro protective ageants etc.

If you can post photos of the affected area,it will be of great help.
Also I would like to know-
Was the rash in patterned distribution?
Was it limited to one side of the body(right)?
Was the rash vesicular (fluid filled)?


Answer the questions and upload the photos and we can continue the discussion here.

Hope this helps.
Regards.

DrSudarshan
MD
Dermatology.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudarshan 12 hours later
The rash was centered on my chest, like a baby's bib. The pain, however, is on the right side. It is mostly right under my right breast, and while the rash is mostly gone, the pain has gotten stronger.

I'm not sure how to upload photos to this web site, and as I said, the rash is mostly gone. But when it appeared, the first sign were two sort of red, rectangular-shaped bumps. They were definitely not hives, and I got a couple more of those the next day when the majority of the rash appeared. It was tiny red bumps - lots of them! - and it was itchy. That was also when I got the first pain in my sternum/breastbone on the right side, which has increased even. As the rash has improved.

As to whether or not the rash was like blisters or fluid-filled, I guess you could say "yes." However, I was careful not to touch them and most were so tiny that I did not ever see fluid come from any.

I hope this additional information helps with your diagnosis.
doctor
Answered by Dr. Sudarshan 6 hours later
Hi again,
Thanks for the details.
Now going by the description it strongly points towards herpes zoster.
The treatment after resolution of rash is analgesics like tramadol ,ibuprofen .Also neuroprotective agents like methylcobalamin ,gabapentin, pregabalin.
These will help a lot in pain and preventing post herpetic neuralgia.
Rest in this period is also very important as physical or mental stress can prolong pain.
Hope this helps.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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