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Rash around corners of mouth, impetigo. Prescribed pennicillin, fucidin, mupirocin. Why does the rash reccur again?

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Posted on Sun, 15 Jul 2012
Question: Hi, 17 days ago i have rash around the corners of my mouth and later spread to below my lower lips and towards chin area. I have been to 5 doctors and it was said to be impetigo. I have had pennicilin, fucidin cream the latest, was precribe mupirocin from the second doctor. When I first took pennicilin and apply the fucidin cream, my rash quickly diminish and dries out. However, after 3 days towards the course, which is 2 days ago, I develop the rash again on the corners of my mouth, lower lips and towards chin, the areas were all red and itchy but i refrain from touching it. At the corners of mouth is also very dry, and previously was dried and cracked and hard to open my mouth. It has improve in terms of not cracking as severely and I could open my mouth properly. Sometimes, only at the corners, it oozes a little bit of clear/light yellow liquid, there's no blisters to be seen but I am not sure if it might be too small to observe. Today the doctor just recommend i take pennicilin with antihistamine together to see if it helps. I am unsure if it is really impetigo, allergy or other bacteria infection. I am worried and not sure what is the next step. To just wait until I finish my course on the pennicilin? And why does it recur again in the midst when I am still taking pennicilin, very confused. It is currently itching a lot at my lower lips and towards chin area, sometimes when i press hard using a tissue paper, it will bleed a little. Thanks for your patience.
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Answered by Dr. P V S Prasad (14 hours later)
Hello
I went through your history and clinical photos.
My opinion is that the rash is not infone for two weeksectious and it is of allergic nature
The possible causes are
1. Lip lick dermatitis due to saliva
2. Cotact dermatitis due to lip cosmetics
3. Irritant dermatitis to any agent
I recommend
1. Mid potent steroid creams like mometasone cream for two weeks
2. Continue cetrizine
3. Stop antibiotics
4. Try to find out the offending agent and stop it
5. Later go for patch test to find the allergen
Have a nice day. I think I have addressed your problem
Pvs XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. P V S Prasad

Dermatologist

Practicing since :1980

Answered : 254 Questions

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Rash around corners of mouth, impetigo. Prescribed pennicillin, fucidin, mupirocin. Why does the rash reccur again?

Hello
I went through your history and clinical photos.
My opinion is that the rash is not infone for two weeksectious and it is of allergic nature
The possible causes are
1. Lip lick dermatitis due to saliva
2. Cotact dermatitis due to lip cosmetics
3. Irritant dermatitis to any agent
I recommend
1. Mid potent steroid creams like mometasone cream for two weeks
2. Continue cetrizine
3. Stop antibiotics
4. Try to find out the offending agent and stop it
5. Later go for patch test to find the allergen
Have a nice day. I think I have addressed your problem
Pvs XXXXXXX