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Suggest treatment for itchy red rashes on buttocks

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Posted on Mon, 12 Oct 2015
Question: Wrote you a week ago about a skin rash on my buttochs near the base of my spine. Tried your remedy of a fungicide creme and bought some Micatin. Seemed to work and I also tried an epsom salt bath in the area. I noticed that the redness was abating and continued for a week or so.
Yesterday, I noticed that the redness came back on my buttochs and the area looks worse than before. Epsom salt bath, once per day in the am and then Micatin twice a day still relieved the itching, but now I found this is spreading to other parts of my body. Yesterday while out in the sun cutting grass, I noticed it starting on my hands with a red blisters ( like on my buttochs. Later on I took another epsom salt bath for the whole body for 30 min. and things felt okay until both my hands felt very dry and started to tingle. I put on some simple lotion first to lube my hands and that did nothing. The redness started to worsen. I then washed and used some Micatin on my hands. i went to bed and in the morning, now, still no change. The tingling is still there like mild needles and pins. I have some new ;pictures -- two new ones from my buttoch and three from my hands.
From some internet research, to me this looks like some kind of contact dermatitis or maybe even poison ivy. Have not been in contact with poison ivy yesterday.
Overall, I believe it all got started from last week at the XXXXXXX beach and lake swim because a day later I noticed itchiness on my buttoch area and started scratching. Anyways, I am wondering if you might still have my first report I sent you last week. I can't get it uploaded to you as I can't reopen the case. I do have new pictures.

Forgot to mention. There is previous report from a week ago and you may not be the same doctor. Please also review the - Other Questions by Me -- as that is the original case. There also are two pictures as well from a week ago.
Thanks
doctor
Answered by Dr. Ilyas Patel (5 hours later)
Brief Answer:
Dermatophytosis -Fungal infection most probabably

Detailed Answer:
Hi,

Welcome to HCM....

I read history and looked at photos. You seem to have fungal infection most probably. Also called dermatophytosis. The lesions on buttock is tinea corporis and that on hands is called tinea XXXXXXX The disease is caused by fungus called dermatophytes.

Perspiration,soap,wetness..etc can precipitate or exacerbate the disease. Internal diseases like DM,HIV or other immunocompromised conditions should be ruled out.

You consult dermatologist for firm diagnosis and perfect treatment. I would like to suggest as below..

- antifungal like ketoconazole,itraconazole or fluconazole may be taken in proper dose till complete cure.

- antihistaminics like levocetirizine 5 mg daily till itch is relieved.

- application of antifungal cream like clotrimazole or setraconazole cream on the lesions

- dettol bath.. Pour few drops in water bucket , avoid soap bath.

- keep the body dry, avoid excessive bathing.

Take treatment after consulting the dermatologist. I hope this would help you. Still, if any question..you may ask.

Thanks.

Dr. Ilyas Patel MD
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Ilyas Patel (2 hours later)
Went to the doctor today. He believes that what's on my hands is different than on my buttoch area. Last week is where the fungus showed up on my butt. Nowhere else. Yesterday, was when my hands got infected. I was shirtless cutting grass and pulling weeds. I believe I came in contact with wild parsnip as there are several plants on my property. As I was cutting grass, I was sweating intensely on my hands and wrists when I noticed a rash start with small red blister- like sores. With wild parsnip which I am certain now to have touched, it actually gets activated by the sun and sweat. Seems to make the case here. I thought nothing further until later in the event. I noticed it had worsened. I took a full Epson salt bath and that dryer the area

Continued here. My hands started to burn a bit more later and also felt tingly in the fingers.
Anyways, I have the exact prescription you suggested for my buttock areas while I have Taro- clobetasol creme for my hands. I also took benedryl to help with the inflammation. Just applied all of this before this message was sent.
I'm convinced it's wild parsnip as I would have grazed by it with contact easily on my hands from pulling weeds. Thought this plant was goldenrod as it looks very similar
Thanks for your efforts.
Sincerely XXXXX
doctor
Answered by Dr. Ilyas Patel (8 hours later)
Brief Answer:
Fungal infection...

Detailed Answer:
Hi,

Welcome back..

As I suggested you seem to have fungal infection of skin of buttock and hands called tinea corporis and tinea XXXXXXX


Kindly follow the line of treatment as suggested under guidance of your dermatologist .


Please avoid steroid cream application,as it might worsen the condition.

I hope this would help you.

Thanks.

Dr. Ilyas Patel MD
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Ilyas Patel (7 hours later)
Thank you for your diagnosis. Below is merely just a follow-up of my observations. No need to respond back if you wish.
You can see why I still believe that what is on my hands is DIFFERENT than on my buttock area. I was pulling weeds two days ago and I know my hands came into contact with wild parsnip. I have the plant as proof for easy reference with pictures from the net. Also, my hands felt tingly and burning -- my buttocks NEVER felt that way -- only itchy. My hands DO NOT feel itchy what-so-ever. My buttock and hands have to be two different phenomena. ( My butt is a fungous problem, my hands are a toxic weed problem ). Most people and doctors have not heard about wild parsnip. It is a relatively new toxic weed. It makes poison-ivy like conditions, except it does not itch like poison ivy does.
I did not know about this plant when I went to the hospital -- I learned of this from later on because I got a tip from one of the nurses. I did not get a chance to inform you in my first writings as I didn't realize it then. ( I wrote you first, then got scared and later went to the hospital ). I am sorry for my ignorance. I should have informed you that I was in contact with wild weeds and the like just before the inflammation on my hands begun. My fault!!
Anyways, this is the second day of applying the Taro-clobetesol to my hands. The tingling and burning is less today and the redness rash is much less. No adverse reaction to the creme as of late. I will continue to apply it as prescribed by the hospital doctor. I am using Ketoderm creme for my buttock area.
Still, thank you for your insights and please accept my view without prejudice or bias. Most of which is my failure to get the facts to you. Thank you again.
doctor
Answered by Dr. Ilyas Patel (4 hours later)
Brief Answer:
You may be right..as you observed

Detailed Answer:
Hi,

Welcome again..

You may be right..you might have irritant contact dermatitis on hands due to weeds.
If it is so,it might cause burning sensation and might respond to oral as well as topical steroid. You consult dermatologist personally and have proper guidance for real treatment. But, kindly get antifungal treatment to improve gluteal rash of fungus.

Wishing you healthy life..

Thanks.

Dr. Ilyas Patel MD
Above answer was peer-reviewed by : Dr. Raju A.T
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Suggest treatment for itchy red rashes on buttocks

Brief Answer: Dermatophytosis -Fungal infection most probabably Detailed Answer: Hi, Welcome to HCM.... I read history and looked at photos. You seem to have fungal infection most probably. Also called dermatophytosis. The lesions on buttock is tinea corporis and that on hands is called tinea XXXXXXX The disease is caused by fungus called dermatophytes. Perspiration,soap,wetness..etc can precipitate or exacerbate the disease. Internal diseases like DM,HIV or other immunocompromised conditions should be ruled out. You consult dermatologist for firm diagnosis and perfect treatment. I would like to suggest as below.. - antifungal like ketoconazole,itraconazole or fluconazole may be taken in proper dose till complete cure. - antihistaminics like levocetirizine 5 mg daily till itch is relieved. - application of antifungal cream like clotrimazole or setraconazole cream on the lesions - dettol bath.. Pour few drops in water bucket , avoid soap bath. - keep the body dry, avoid excessive bathing. Take treatment after consulting the dermatologist. I hope this would help you. Still, if any question..you may ask. Thanks. Dr. Ilyas Patel MD