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Noticed red spots on chest. Feel itching. Become dry patches. Fear of Psoriasis?

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Answered by

Practicing since : 2006
Answered : 2015 Questions
Hello Doctor,
I wanted to consult with a doctor for a long on a skin condition I have. I have this condition for at least the last 4 years. Since it wasn't troubling much me I ignored. Today I decided to consult with a doctor after reading an article in the internet about this condition. Between my two chests I could see a bunch of red dotted spots when itching, it's become dry patches when it's not itching. These spots appear only when I start to scratch that area. Once in a while (say once or twice in a month) I have itching on this area. If I start to scratch to get a relief from itching then these spots become more visible and reddish and also I could see the blood (certainly not bleeding but in very very minute quantity ). The more I scratch the more it itches. After 5-10 minutes the itching automatically stops if I reduce scratching repeatedly over the area. After this in a couple of days I could see skin flakes over the area. I have attached a couple of pictures for you to get a clear idea about the condition. This picture was clicked in a normal condition i.e. when there was no itching over the area. Also the last 10 days I notice few spots below my palm and on the back of the palm. These spots are not itching, it doesn't trouble me any way. Few spots are seen on my fingers and also on the back side of my fingers. I have attached a couple of pictures for this as well. I fear these conditions put together are a mild form of psoriasis. Please advise me on what to do next? Is it something serious especially I am worried about the small dry patches on my palms and fingers. I visited a GP for the condition on my palms, he prescribed me Tetmasol soap, Forcan-150 (one pill every week), Becosules every day after breakfast.
Posted Sun, 29 Sep 2013 in Skin Hair and Nails
Answered by Dr. Kalpana Pathak 31 minutes later
Brief Answer:
It looks like eczema.

Detailed Answer:
Thanks for writing to us.
From the description provided and the images attached, it probably looks like eczema. It does not look like psoriasis. Psoriasis lesions are not severely itchy and do not wax or wane so often.
Another possibility could be fungal infection but as far as my clinical acumen goes, it is probably eczema

The treatment provided by your doctor is meant for fungal infections but is little vague. Becosule and tetmasol won't help in fungal infection

Eczema usually flares up with itching.

To treat the same,
Take an antihistaminic every day
Apply steroid cream like mometasone twice in a day to affected area.

Hopefully in few days the lesions should completely subside.

Hope that answered your query. Should there be a doubt, please write back. I shall be available for follow up.

Take care
Above answer was peer-reviewed by
Follow-up: Noticed red spots on chest. Feel itching. Become dry patches. Fear of Psoriasis? 1 hour later
Thanks very much for answering my query doctor. Coming to the point about the skin condition on my palms and fingers I have attached another picture. I see these small dry white patches just for the last 10 days. I could see these small white patches on both the hands below the palms as highlighted in the picture. Also I see few spots on the palm, back of the fingers but I don't see such patches anywhere else in the body. These patches are not irritating, itching or nor disturbing me.

1. Is this eczema too?
2. Are they both (condition on my chest and on my palms) related?
3. Should I follow the same medicines prescribed above for this condition too?

Please prescribe me medicines if it's different for this condition.

Many thanks.

Answered by Dr. Kalpana Pathak 17 hours later
Brief Answer:
Please see a detailed answer below

Detailed Answer:
Thanks for writing back.

The images that you have attached shows mild peeling of skin over your wrist area, fingers etc. Initially might be there was a small skin colored pin point lesion that resolved with peeling of skin.

1) this could be eczematous too. A variant of eczema presents with small pin point deep seated fluid filled lesions that resolve with peeling of skin
2) these could be related, however could be different variants of eczema
3) Please follow the medicines suggested in my previous post and let me know in three or four days, how much response have you achieved. The medicines are to be applied over chest as well as hands.

Also I would like to know if your scalp is flaky or itchy ie having greasy dandruff.

Hoping to hear from you soon.
Take care
Above answer was peer-reviewed by
Follow-up: Noticed red spots on chest. Feel itching. Become dry patches. Fear of Psoriasis? 11 minutes later
Thanks for the explanation doctor. Sure I will follow the medicines prescribed by you above. I think there was no small skin colored pin point lesion that resolved with peeling of skin. It just appears the way how it is highlighted in the picture. I never seen any lesions in those areas before. I use head and shoulders regularly. If I stop using it then for sure I will have the small flaky patches on my scalp. I have this condition since my teenage.

You have prescribed "antihistaminic" drug. Could you please help me with the drug company name and the dosage please?

Many thanks,
Answered by Dr. Kalpana Pathak 17 hours later
Brief Answer:
Antihistaminic drug- levocetirizine

Detailed Answer:
Thanks for writing back.
The question regarding scaly or flaky scalp was asked as sometimes seborrheic dermatitis can have similar presentation over chest area.
Seborrheic dermatitis is a variant or type of eczema only.

As you never developed any pin point fluid filled lesions prior to peeling over hands or fingers, it could be keratolysis exfoliativa or focal palmar peeling. It is a seasonal condition which improves on own. However application of moisturising cream and steroid cream helps in faster resolution.

So the treatment plan would be

Use ketoconazole shampoo like keraglo Ad or scalpe or nizoral etc every alternate days. Apply over scalp and wash off after five minutes. Once scalp flakiness improves, use it once in a week as a maintenance therapy

As already advised take an antihistaminic like levo cetrizine ( levosiz, HHlevo etc) once to twice in a day depending on severity of itching
Apply mometasone cream twice in a day over chest and hands.

Follow these suggestions for a week and get back to me for follow up.

Take care
Above answer was peer-reviewed by
Follow-up: Noticed red spots on chest. Feel itching. Become dry patches. Fear of Psoriasis? 5 days later
Hello Doctor,

I have a new skin condition.

1) Dry patches of skin on my thighs, elbows, hands ands legs. It's not itching or irritating. I have attached photos for ur examination.

please advise on what has to be done next.
Answered by Dr. Kalpana Pathak 37 hours later
Brief Answer:
The lesions look eczematous

Detailed Answer:
Thanks for writing back.
Firstly accept my apologies for much delayed response.
I have gone through the images attached, the lesions look eczematous and probably due to dry skin condition.These do not look like lesions of psoriasis or fungal infection.
As advised earlier, please use steroid cream to treat these lesions as well. If your skin is dry, use a good moisturising cream meant for dry skin like cetaphil, venusia XXXXXXX etc.

The lesions would probably resolve in a week.
Hope that answered your query.
Take care
Above answer was peer-reviewed by
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