Brief Answer:
Kindly provide more information; upload photographs

Detailed Answer:
Hello. Thanks for writing to us at healthcaremagic

I am Dr. Kakkar. I have gone through your query.

Provide me more information regarding your query

-Are there any symptoms?like itching?are the bumps/acne painful?
-Where are the rashes and acne situated on the legs?

Kindly upload a photograph so that I am able to understand the condition better and therefore guide you better

Your treatment history mentions a topical cream. This cream is a combination of a potent topical steroid with a topical antibiotic, clobetasol propionate 0.05%+ Gentamicin 0.1%.
How long have you been using this cream?Has it helped?

Regards

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Brief Answer:
Possibility of Scabies

Detailed Answer:
Good morning

I have reviewed the photographs.

The salient feature in your history is: Itchy lesions for 3 months, responding to topical potent steroid but recurring as soon as you stop using the cream.

If I was the treating doctor, I would keep a possibility of scabies and would have treated you empirically for scabies.

Single whole body application of 5% Permethrin lotion, kept overnight for 8 hours, followed by scrub bath next day; alternatively a single dose of Ivermectol can also be given.

An OTC oral antihistamine e.g cetrizine 10 mg once daily would provide you symptomatic relief from itching.

Any other member in the family who has the same symptoms?itching and bumps?
Is the itching more at night (nocturnal)?

Regards

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Brief Answer:
Possible scabies

Detailed Answer:
Hi

Scabies commonly presents as itchy lesions on thighs and legs. It may involve other sites like abdomen, torso and arms as well.
However in those who have a good hygiene it may not become as florid so as to involve other body sites and mostly remains localized.
Moreover, itching is a subjective symptom in individuals. Also because you are already applying a potent topical steroid therefore that also mitigates itching a lot.
Family history is just a supportive finding and absence of family history does'nt rule out scabies either.
I kept this possibility because the condition has been recurring for past 3 months and it is itchy.
It is worth treating for scabies in such a scenario
The lesions such as you have described and as I can see in the photographs, can occur in scabies. In scabies the lesions primarily start as red bumps which look like mosquito bite; they can be fluid filled, which can be either clear fluid or pus (if they get infected)
The location, itching and the type of lesions are indicative of scabies. Therefore I would suggest empirical treatment for scabies as before.
The cream which you have already been using would just provide you symptomatic relief from itching and temporarily settle down the lesions because it contains a potent steroid(steroids are antiinflammatory). It will not be curative in scabies.
For scabies you need to use a cream containing 5% permethrin and apply as instructed. It is however a prescription drug.

Regards

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Brief Answer:
Visit a dermatologist

Detailed Answer:
Hi.

Yes, permethrin is a prescription product. It is not available OTC.
Surely the earlier diagnosis needs to be reviewed by your treating dermatologist since your skin condition has persisted for 3 months.
I would suggest that you seek another appointment with your dermatologist for a review of your skin condition.

Regards

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