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Suggest Treatment For Small Red Pimples On Breast
Question: I have gone to 3 different doctors and they all told me this rash is a fungal infection. Despite taking several antibiotics and taking fungal medications as well as fungal cream, the rashes keep getting bigger and spreading. I first started out with a small red pimple like rash on my rt. breast that got bigger and now i have it throughout my body. I would like to hear from a specialist but no Dermatologist in my town can see me until Feb.
Brief Answer:
It suggests a possibility of either discoid dermatitis Or P. rosea.
Detailed Answer:
Hello. Thank you for writing to us at healthcaremagic
I have gone through your query and I have also seen the images. The image that I have got is of a forearm and I can see a dry, scaly, red patches.
No XXXXXXX to me that it is not responding to antifungal because this does not look like a fungal infection.
I wonder why you were asked to take the antibiotics. Were the antibiotics prescribed because patches were Oozing?
I will keep a possibility of either "Dry Discoid Dermatitis" Or "Pityriasis Rosea"
I would like to gather more information from you regarding the query so that I am able to guide you better.
-How long do you have these patches?
-Where all are the patches distributed? Are the patches more on the torso? What about legs and upper arms?
-How severe is the itching? Mild or extreme?
-Do the patches ooze as well?
-Which part of the world is you located? Is the weather cold and dry there?
-Can you upload a few more Images of patches elsewhere?
Kindly provide me point by point answer to all my specific queries.
Regards
It suggests a possibility of either discoid dermatitis Or P. rosea.
Detailed Answer:
Hello. Thank you for writing to us at healthcaremagic
I have gone through your query and I have also seen the images. The image that I have got is of a forearm and I can see a dry, scaly, red patches.
No XXXXXXX to me that it is not responding to antifungal because this does not look like a fungal infection.
I wonder why you were asked to take the antibiotics. Were the antibiotics prescribed because patches were Oozing?
I will keep a possibility of either "Dry Discoid Dermatitis" Or "Pityriasis Rosea"
I would like to gather more information from you regarding the query so that I am able to guide you better.
-How long do you have these patches?
-Where all are the patches distributed? Are the patches more on the torso? What about legs and upper arms?
-How severe is the itching? Mild or extreme?
-Do the patches ooze as well?
-Which part of the world is you located? Is the weather cold and dry there?
-Can you upload a few more Images of patches elsewhere?
Kindly provide me point by point answer to all my specific queries.
Regards
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
I live in South XXXXXXX where it is mostly hot here but one day it can be cold then the next hot. It is also humid here. I do not go outside for work or anything, I work indoors. I had a very small dot on my rt. breast over 4 weeks ago then it turned into the big red rash that you see on the 2nd uploaded image thats on my rt. breast. I first went to the doctor for that on 11/24/14 and that was the only spot I had. Then I went again on 12/01/14 because it had gotten bigger and I had more on my arms, breast, rt. foot. After that visit I noticed more and more coming out. They do not ooze and I also have many more small ones on both my breasts and under my breasts. I have some on my abdomen, both arms, 3 on my rt. leg, 1 on my left leg, many on my rt. foot, one on my lft. foot, 3 on my rt. buttocks, maybe like 4 on my back, one on my bilateral thighs, and 3 near my inner right thigh. The majority of them seem to be on my right side of the body. The majority are also on my breast and bilateral forearms. They itch sometimes but rarely, they only start to itch if I mess with them or accidentley hit them or something, then they start to itch. The pictures I sent last that show very small dots and minimal distribution is when the rash first started, but the rashes are now bigger as you can see from the first picture I uploaded.
I forgot to mention that sometimes when applying the Nystatin cream the rash burns and itches. Also I noticed I have some patches on my scalp.
Shortened answers. Look at above post for more detailed.
1. First patch started as a dot on rt. Breast then got bigger so I went to the doctor on 11/24/14. Then back on 12/1/14 because it had gotten bigger and I noticed more dots coming out on my hands, abdomen, feet.
2. The patches are distributed more on my chest, breast and bilateral arms. In the upper arms I have maybe like 2 or 3 on each side. On my rt. Leg I have maybe like 3 and L. leg 1.
3. The itching is moderate I guess. Most of the time it doesn’t itch unless I mess with them but there are times that it itches more than other times.
4. The patches do not ooze.
5. I am in South XXXXXXX where it is humid. Most of the time even in winter it is hot but one day it can be cold and the next day hot.
I forgot to mention that sometimes when applying the Nystatin cream the rash burns and itches. Also I noticed I have some patches on my scalp.
Shortened answers. Look at above post for more detailed.
1. First patch started as a dot on rt. Breast then got bigger so I went to the doctor on 11/24/14. Then back on 12/1/14 because it had gotten bigger and I noticed more dots coming out on my hands, abdomen, feet.
2. The patches are distributed more on my chest, breast and bilateral arms. In the upper arms I have maybe like 2 or 3 on each side. On my rt. Leg I have maybe like 3 and L. leg 1.
3. The itching is moderate I guess. Most of the time it doesn’t itch unless I mess with them but there are times that it itches more than other times.
4. The patches do not ooze.
5. I am in South XXXXXXX where it is humid. Most of the time even in winter it is hot but one day it can be cold and the next day hot.
Brief Answer:
A skin biopsy is indicated; I have kept psoriasis and P.rosea as differentials
Detailed Answer:
Hi.
Thank you. I have reviewed the Images.
It is unusual to have such an extensive but patchy fungal involvement; though the lesions under breasts and inner thighs may have initially led your doctor to suspect these being fungal in origin as these sites are commonly involved in fungal infections.
Anyway, I have already rule out fungal infection. You can forget about it.
The distribution is not typical of dry discoid dermatitis and therefore I rule it out. Moreover discoid dermatitis is more common in cold and dry weather conditions.
Scalp involvement is a significant finding and suggests another possibility, that of Psoriasis. A skin biopsy would be confirmatory.
I will keep a possibility of Pityriasis Rosea as my second differential diagnosis.
In both of these conditions there are scaly patches, which are itchy and red.
Psoriasis is a definite possibility; scalp involvement with itchy, scaly patches is classically of psoriasis. Psoriasis can involve widespread areas with scaly itchy patches.
In Pityriasis rosea, patches are commonly distributed over the torso, proximal extremities and distal parts like hands and feet are rarely involved.
The patches of pityriasis roseas are classically oriented along the ribs, which seems like a christmas tree pattern, though this pattern may not be always seen.
If I was the treating doctor I would have biopsied one of the lesions and sent it for histopathological examination.
I would keep 2 differentials: psoriasis and pityriasis rosea.
A cream containing a potent topical steroid e.g clobetasol propionate would have proved beneficial in both of these conditions. It is a prescription topical steroid.
An OTC oral antihistamine e.g cetrizine 10 mg once daily will provide you symptomatic relief from itching.
I would suggest that you review with your dermatologist; fix up an early appointment if possible.
Regards
A skin biopsy is indicated; I have kept psoriasis and P.rosea as differentials
Detailed Answer:
Hi.
Thank you. I have reviewed the Images.
It is unusual to have such an extensive but patchy fungal involvement; though the lesions under breasts and inner thighs may have initially led your doctor to suspect these being fungal in origin as these sites are commonly involved in fungal infections.
Anyway, I have already rule out fungal infection. You can forget about it.
The distribution is not typical of dry discoid dermatitis and therefore I rule it out. Moreover discoid dermatitis is more common in cold and dry weather conditions.
Scalp involvement is a significant finding and suggests another possibility, that of Psoriasis. A skin biopsy would be confirmatory.
I will keep a possibility of Pityriasis Rosea as my second differential diagnosis.
In both of these conditions there are scaly patches, which are itchy and red.
Psoriasis is a definite possibility; scalp involvement with itchy, scaly patches is classically of psoriasis. Psoriasis can involve widespread areas with scaly itchy patches.
In Pityriasis rosea, patches are commonly distributed over the torso, proximal extremities and distal parts like hands and feet are rarely involved.
The patches of pityriasis roseas are classically oriented along the ribs, which seems like a christmas tree pattern, though this pattern may not be always seen.
If I was the treating doctor I would have biopsied one of the lesions and sent it for histopathological examination.
I would keep 2 differentials: psoriasis and pityriasis rosea.
A cream containing a potent topical steroid e.g clobetasol propionate would have proved beneficial in both of these conditions. It is a prescription topical steroid.
An OTC oral antihistamine e.g cetrizine 10 mg once daily will provide you symptomatic relief from itching.
I would suggest that you review with your dermatologist; fix up an early appointment if possible.
Regards
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
The ones on my scalp almost look like cradle cap like babies get so I may have 2 things going on. My next question is since this rash is in my hands and I am a registered nurse and work in an oncology hematology floor where I administer chemotherapy and have immunocompromised patients I am scared of exposing my skin to other possible infections like C.diff,MRSA, Hep C and so forth so I have not been to work. Do you think it is okay for me to return to work or go see a dermatologist first as soon as possible?
Brief Answer:
Visit a dermatologist; no risk in terms of infection; can resume work.
Detailed Answer:
Hi.
Cradle cap like scaling is quite typical of psoriasis/sebopsoriasis.
You can return to work as soon as you desire. There is no risk whatsoever in terms of getting infection at your work place just because of this skin condition.
I suggest a skin biopsy for a confirmatory diagnosis of psoriasis. Early visit to a dermatologist would be good because you will require prescription medicines
Regards
Take care
Keep me informed.
Visit a dermatologist; no risk in terms of infection; can resume work.
Detailed Answer:
Hi.
Cradle cap like scaling is quite typical of psoriasis/sebopsoriasis.
You can return to work as soon as you desire. There is no risk whatsoever in terms of getting infection at your work place just because of this skin condition.
I suggest a skin biopsy for a confirmatory diagnosis of psoriasis. Early visit to a dermatologist would be good because you will require prescription medicines
Regards
Take care
Keep me informed.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Okay thank you I will keep you informed.
Brief Answer:
Welcome
Detailed Answer:
Thank you
Regards
Welcome
Detailed Answer:
Thank you
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. Bhagyalaxmi Nalaparaju
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