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Itchy Rash Just The Right Of Spine. Applied Corticosteroid Ointment, No Improvement. What Could Be This?

Posted on Fri, 24 Aug 2012

Question: I am a Registered Nurse. I noticed a quarter size itchy rash just the right of my spine up near my shoulder area approx two weeks ago. I saw our employee health nurse and was diagnosed with contact dermatitis d/t lack of a better diagnosis and given a corticosteroid ointment. There was no improvement over the next several days and on the fourth day I noticed the rash had actually spread just slightly. There was not really any pain to speak of so shingles was not really something I suspected. I saw the nurse again three days ago and was given a medrol dose pack. There is still no improvement and I am now experiencing increasing pain and am fairly certain that what I actually have is shingles. Does this sound like shingles to you and if so what would be your tx plan? Also I am an avid exerciser and am curious about any possible complications or concerns I should consider before hitting the gym?

Answered by Dr. Robert Galamaga (49 minutes later)

Hello and thank you for submitting your question.

Your question is a very good one and I will work on providing you with some information and recommendations.

It can sometimes be difficult to differentiate between contact dermatitis and early shingles. I think at this point due to the fact that you have not responded to both topical and oral steroids and the area you have described is now becoming painful that we need to change the course of your treatment towards that which addresses a case of shingles.

The Medrol actually would be part of the treatment of shingles in some cases. We use steroids in addition to antiviral medications to help lessen the severity of the pain that is associated with the shingles. At this point I would recommend treatment with Valtrex.

The recommended dose for Valtrex is 1000 mg every eight hours for seven days. I would recommend that you see the nurse again or contact your symptoms but it will generally shorten the duration of the illness and hopefully minimize the likelihood that you'll have any long-term issues with pain.

Thanks again for submitting your question. I hope you have found my response to be helpful and informative. If you have additional concerns I would be happy to address those.

Sincerely,

Dr Robert

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

Follow up: Dr. Robert Galamaga (13 hours later)

Any reason I can't continue to workout?

Answered by Dr. Robert Galamaga (4 hours later)

You can continue to work out but I would recommend that any rash should be covered by your clothing. Generally we consider the rash to be potentially contagious by touch until the areas crusted over completely.

Thanks again for submitting your question.

Dr. Galamaga

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