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Suggest Treatment For Persistent Rash On Arms And Face
Question: Hi there about 8 months ago I developed a rash on my arms and face after painting my sons cabinet... I received two intra muscular steroid shots and oral prednisolone 25 mg daily for seven days ... Upon stop I broke out in a rash and my skin all went very pink or reddish colour ... Gp put me on additional two more weeks 25 mg everyday and came down to 10 and stop ... Something happened ... This time he didn't put me in steroid ... It's 8 months now I am still red and my complection has fully changed, I have developed wrinkles and strech marks all over ... They have done morning cortisol and blood results looks all good... My question is is this redness permanent? My skin has thinned madly .. Will I ever again have my dark complection back? It feels like someone has bleached me ... I have become heat and sun sensitive ... Please help thanks
Brief Answer:
Stretch marks are permanent; Redness would decrease with time.
Detailed Answer:
Hello. Thank you for writing to us
I have gone thorough your query in detail and I have noted down your concern.
Depo steroid shots and Oral prednisolone can cause skin to thin and turn red along with formation of stretch marks. These are well known side effects of exogenous steroid administration.
Stretch marks can first start appearing days or weeks after patient is put on injectable Or Oral steroids and may continue to worsen for sometime even after all steroids are discontinued.
Early stretch marks are red/ purple though the redness would decrease over time and they would turn white later on. However, stretch marks are permanent.
Skin thinning and redness should reverse with time provided you are off any more exogenous steroids.
I suggest that you use a broad spectrum sunscreen, throughout the day, particularly on exposed skin, specially when you move out during the day.
Your skin would be thin and photosensitive for sometime and therefore you need to protect it from sun till it recovers.
I would request that you upload a few representative Images of the affected skin areas which concern you..
You can upload an Image either at "Reports Section"
Or
You may also mail Images at YYYY@YYYY with the subject line of this mail as Attn: Dr. Kakkar.
Regards
Stretch marks are permanent; Redness would decrease with time.
Detailed Answer:
Hello. Thank you for writing to us
I have gone thorough your query in detail and I have noted down your concern.
Depo steroid shots and Oral prednisolone can cause skin to thin and turn red along with formation of stretch marks. These are well known side effects of exogenous steroid administration.
Stretch marks can first start appearing days or weeks after patient is put on injectable Or Oral steroids and may continue to worsen for sometime even after all steroids are discontinued.
Early stretch marks are red/ purple though the redness would decrease over time and they would turn white later on. However, stretch marks are permanent.
Skin thinning and redness should reverse with time provided you are off any more exogenous steroids.
I suggest that you use a broad spectrum sunscreen, throughout the day, particularly on exposed skin, specially when you move out during the day.
Your skin would be thin and photosensitive for sometime and therefore you need to protect it from sun till it recovers.
I would request that you upload a few representative Images of the affected skin areas which concern you..
You can upload an Image either at "Reports Section"
Or
You may also mail Images at YYYY@YYYY with the subject line of this mail as Attn: Dr. Kakkar.
Regards
Above answer was peer-reviewed by :
Dr. Prasad
Hi there thanks so you dont think it will be cushing syndrome? I keep breaking out in rashes as well ... Is this steroid rebound? Its so uppsetting... Also 9 months have passed since i have stopped the use of steroids ( whuch was only for 3 weeks) will the healing process take few years? Thanks heaps i have attached a photo ofthe recent rash i have had thanks
Brief Answer:
You may use topical benzoyl peroxide gel for acneform eruptions
Detailed Answer:
Hi.
Thank you. I have reviewed the Image.
In this Image I can see that you have acneform eruptions on arm and shoulders. This is also a well known side effect of steroids.
Stretch marks and acneform eruptions are both side effects of excessive steroids administration/ abuse.
Cushing's syndrome includes a whole gamut of other manifestations like moon facies, weight gain, high blood pressure, high blood sugar, high cholesterol levels, hirsutism and irregular periods in females, and bone thinning or osteoporosis etc and patients usually don't have a full blown cushing's syndrome by just being on 3-4 weeks of exogenous steroids!
An endocrinologist after a thorough clinical examination and laboratory tests would be in a better position to decide whether you have full blown cushing's syndrome or not, however, one thing is for sure that you should not be on any more exogenous steroids.
Acneform eruptions are reversible.
I usually manage these in the same way as acne. You may try a topical antiacne antibacterial e.g 2.5% benzoyl peroxide gel, twice daily, for these.
Regards
You may use topical benzoyl peroxide gel for acneform eruptions
Detailed Answer:
Hi.
Thank you. I have reviewed the Image.
In this Image I can see that you have acneform eruptions on arm and shoulders. This is also a well known side effect of steroids.
Stretch marks and acneform eruptions are both side effects of excessive steroids administration/ abuse.
Cushing's syndrome includes a whole gamut of other manifestations like moon facies, weight gain, high blood pressure, high blood sugar, high cholesterol levels, hirsutism and irregular periods in females, and bone thinning or osteoporosis etc and patients usually don't have a full blown cushing's syndrome by just being on 3-4 weeks of exogenous steroids!
An endocrinologist after a thorough clinical examination and laboratory tests would be in a better position to decide whether you have full blown cushing's syndrome or not, however, one thing is for sure that you should not be on any more exogenous steroids.
Acneform eruptions are reversible.
I usually manage these in the same way as acne. You may try a topical antiacne antibacterial e.g 2.5% benzoyl peroxide gel, twice daily, for these.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks heaps that sounds like what i have got and they have certaiy given me more steroids than i needed.. Will this pinkish redish skin and thining reverse as well? Or is it permanent? I break out once every few weeks ... The rash goes away but i am real wirried my thin fragile skin will last forever .. Thanks :(
Brief Answer:
Redness and pinkish skin of stretch marks should resolve with time
Detailed Answer:
Hi.
The pinkish reddish skin within stretch marks should go with time and ultimately the stretch mark would be a whitish color.
However the thinning/ atrophy of stretch mark Or defect i.e stretch mark itself would remain for ever.
You may take an OTC oral antihistamine e.g cetrizine 10 mg next time a rash breaks out rather than on being on Oral steroids.
I would like to gather more information about the rash that you continue to break out...
-Is it itchy? Is it the same type of rash for which you were first started on Oral and injectable steroids?
-How long does it last before it resolves?
-What do you do for it when it occurs? Does it resolves by itself?
-Can you upload a few more Images of the rash? as many as you can..
Regards
Redness and pinkish skin of stretch marks should resolve with time
Detailed Answer:
Hi.
The pinkish reddish skin within stretch marks should go with time and ultimately the stretch mark would be a whitish color.
However the thinning/ atrophy of stretch mark Or defect i.e stretch mark itself would remain for ever.
You may take an OTC oral antihistamine e.g cetrizine 10 mg next time a rash breaks out rather than on being on Oral steroids.
I would like to gather more information about the rash that you continue to break out...
-Is it itchy? Is it the same type of rash for which you were first started on Oral and injectable steroids?
-How long does it last before it resolves?
-What do you do for it when it occurs? Does it resolves by itself?
-Can you upload a few more Images of the rash? as many as you can..
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi there ... Thanks for getting back to me... I am more concerned of general pinkness to skin( its everywhere as uf the while akin XXXXXXX my bidy has thinned) and alteration of my complexion, and the fact that i am so sun sensitive and cant tolerate warm bath as my skin gets even more red ... Also dryness of my skin is so severe too due to steroids which would be good to know if it will resolve over time or not... As for the rash yes these new ones do look like the original rash. Just the original one was more severe and covered my face... To start off they r not so itchy but afte two days they do tend to get itchy... As i didnt want to go back on steroids i have been using. Oathmeal cream on them and they seem to go down ovwr few days though for the whole bumpiness to disapear it takes around two weeks ... I have to mention that the original rash is weather due to steroid shots that i recieved in the bursa or cold sore virus that i caught off my son ... Thats the only two major events that had happened around the time i developed the rash ... Also my gp has put me on oral birth control pills ( levlen Ed) to help with acne that i have developed but i am just worried it will make things worse ... Do you think the general sun sensitivity and redness and dryness will go away or is it general skin atrophy? Thanks heaps ... Also i have developed indented dark patches on my skin which is odd .. I have no photo of the original rash unfortunatly and just have the photo of the recent one due to loosing my previous phone ... Thank again for your help s
Brief Answer:
I suggest a skin biopsy and histopathology for a confirmatory diagnosis
Detailed Answer:
Hi.
Generalized redness (possibly erythroderma) and thinning is certainly not due to steroid shots/ oral steroids that you received for just 3-4 week period, 8 months back!
I am also equally concerned about the rash that keeps breaking out repeatedly.
Systemic steroids certainly seemed to benefit this rash (i. e steroid responsive) when it first appeared 8 months ago, transiently though.
I don't think that the recurrences of rash is due to a steroid rebound.
Knowing more about the characteristics of the rash, in your last reply, I retract my original possibility of acneform eruptions.
This looks more like a dermatitic rash; it is itchy, steroid responsive, recurrent plus there is generalized redness (possibly erythroderma).
I suggest that you use a broad spectrum sunscreen, throughout the day, on all exposed skin.
Continue with oatmeal moisturizer, twice daily.
At this point, from whatever I could gather from your description without any pictures of course, I would suggest that a Skin Biopsy and Histopathology, from one of these skin lesions is required for a confirmatory diagnosis.
A visit to a dermatologist in person would be worthwhile for a review.
In the mean time if rash recurs kindly get back to me directly along with the pictures.
Here is my profile: http://doctor.healthcaremagic.com/doctors/dr-kakkar-s/66939
Regards
I suggest a skin biopsy and histopathology for a confirmatory diagnosis
Detailed Answer:
Hi.
Generalized redness (possibly erythroderma) and thinning is certainly not due to steroid shots/ oral steroids that you received for just 3-4 week period, 8 months back!
I am also equally concerned about the rash that keeps breaking out repeatedly.
Systemic steroids certainly seemed to benefit this rash (i. e steroid responsive) when it first appeared 8 months ago, transiently though.
I don't think that the recurrences of rash is due to a steroid rebound.
Knowing more about the characteristics of the rash, in your last reply, I retract my original possibility of acneform eruptions.
This looks more like a dermatitic rash; it is itchy, steroid responsive, recurrent plus there is generalized redness (possibly erythroderma).
I suggest that you use a broad spectrum sunscreen, throughout the day, on all exposed skin.
Continue with oatmeal moisturizer, twice daily.
At this point, from whatever I could gather from your description without any pictures of course, I would suggest that a Skin Biopsy and Histopathology, from one of these skin lesions is required for a confirmatory diagnosis.
A visit to a dermatologist in person would be worthwhile for a review.
In the mean time if rash recurs kindly get back to me directly along with the pictures.
Here is my profile: http://doctor.healthcaremagic.com/doctors/dr-kakkar-s/66939
Regards
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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