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Reddish Pink Marks. Diagnosed With Ring Worm. Given RX Cream. Why Is It Not Leaving? Due To Sweat?

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Posted on Wed, 4 Jul 2012
Question: These marking are not itchy. They are a reddish pink. the left is oval, the right is odd shaped. I was diagnosed with the left axilla area (it is below the area of shaving though, below the armpit triangular area) as being ringworm and given and RX for cream called Ketoconazole back in May 2011. It didn't help at all. No scrappings were done, no woods lamp, just by eyeballing it. The right axilla area marking is slightly lower than the left and that I noticed after a strenous week of exercise last summer, but it never went away. Both sides are in line with the side of my breasts on the ribcage to the side underneath armpit area. I thought it was from being sweaty and my bra and clothes rubbing there. I have tried everything on these marks. Hydracortisone, Bio Oil, even the retin A I have for my acne break outs. Any clues as to what these marks are? BTW, I am 43 years old.
doctor
Answered by Dr. Gaurang Krishna (46 minutes later)
Hello ,

Thanks for writing in.

After seeing the pic, ringworm is the first thing that comes to mind. But, persistence of the lesion for more than 9 months is highly unusual for ringworm.

Other possibilities include Herald Patch of P.Rosea ( again unlikely for this long duration), Discoid Dermatitis (unlikely because it is non-itchy).

So, I think the time has to come to investigate it properly. I feel that taking a biopsy of the lesion is the best way forward (I would like to rule out parapsoriasis and borderline tuberculoid leprosy).

Please be informed that getting a biopsy done does not mean that there is a suspicion of cancer. A biopsy is a very commonly employed tool for diagnosing skin lesions.

I would suggest you to see a dermatologist again and proceed with getting a biopsy done. Things will be much clearer then.

In the meantime you may use a good emollient like Cetaphil cream 2-3 times daily.

Please feel free to ask me any further questions you have,

Thanks
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Gaurang Krishna (4 minutes later)
parapsoriasis and borderline tuberculoid leprosy? OMG. Leprosy? Anything else come to mind? I am very worried.
doctor
Answered by Dr. Gaurang Krishna (51 minutes later)
see, Leprosy is just a possibility. It is very very very rare in Western Countries.
But on the right axilla, I can see a satellite lesion thats why leprosy comes to mind. And as a golden rule in dermatology, we have to keep a broad mind when the diagnosis is very uncertain and give the pathologist different possibilities to look into.

Do not be worried.
Just get yourself tested. The chances of leprosy is less than a percent.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Gaurang Krishna (9 minutes later)
parapsoriasis includes cutaneous t-cell lymphoma and MF. I looked at all these pictures online and I can't say mine look like either of those or leprosy. Would my children and husband catch the leprosy?
doctor
Answered by Dr. Gaurang Krishna (11 minutes later)
Sure.

Thats why I said I want to rule these things out. It means that there is a very very small possibility and it is not a serious possibility.
CTCL and MF are advanced and neoplastic forms. Parapsoriasis is benign and a term given to psoriasiform dermatitis.

Internet is a XXXXXXX tool ma'am. Gives you a lot of unwanted information.

Leprosy has a varied presentation. Your lesion does look like a little pale in the centre (on the photograph).

And when I talk about leprosy, it is the mildest form which is non infectious. So you need not worry about transmitting it to others,

I am sorry, I think I have unnecessarily worried you up. Please relax.
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
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Answered by
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Dr. Gaurang Krishna

Dermatologist

Practicing since :2006

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Reddish Pink Marks. Diagnosed With Ring Worm. Given RX Cream. Why Is It Not Leaving? Due To Sweat?

Hello ,

Thanks for writing in.

After seeing the pic, ringworm is the first thing that comes to mind. But, persistence of the lesion for more than 9 months is highly unusual for ringworm.

Other possibilities include Herald Patch of P.Rosea ( again unlikely for this long duration), Discoid Dermatitis (unlikely because it is non-itchy).

So, I think the time has to come to investigate it properly. I feel that taking a biopsy of the lesion is the best way forward (I would like to rule out parapsoriasis and borderline tuberculoid leprosy).

Please be informed that getting a biopsy done does not mean that there is a suspicion of cancer. A biopsy is a very commonly employed tool for diagnosing skin lesions.

I would suggest you to see a dermatologist again and proceed with getting a biopsy done. Things will be much clearer then.

In the meantime you may use a good emollient like Cetaphil cream 2-3 times daily.

Please feel free to ask me any further questions you have,

Thanks