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What Causes Itchy, Painful, Hot Rashes Across The Chest And Upper Arms?

Posted on Wed, 8 Jun 2016

Question: my mother has had a very itchy, painful,hot, dry, raised rash accross chest and upper arms, for weeks. it is spreading to neck and lower arms. been treated w/ antibiotics, antifungal, steroids (topical and oral). Nothing has had much positive affect. shes been told, next step is a biopsy. opinion?

Answered by Dr. Dr. Rahul Kumar (1 hour later)

Brief Answer:
Cellulitis

Detailed Answer:
Hello
Thanks for the query.
It can be cellulitis, a bacterial infection of the deep tissue.
Can you please upload a photograph of the involved area.
This will help me in giving a closer diagnosis.
Waiting for your response.
Thank you.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Rahul Kumar (12 hours later)

I will go see my mother tomorrow, and send you a picture. The rash is raised, red, dry and scaly; some looks "plaque like". Its horizontally across her chest, shoulders and upper arms in front, in mass. All at the relative same level vertically. It is spreading, a little, up to neck and lower arms. Will send pix tomorrow.
thanks, XXXXXXX

Answered by Dr. Dr. Rahul Kumar (26 hours later)

Brief Answer:
Waiting for your response

Detailed Answer:
waiting for your response.
Thank you.

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Dr. Rahul Kumar (5 hours later)

Dr. Kumay,
Am having diffuculty sending picture to you; can't seem to bring it to this site.
Its raised, red patches, accross the chest, upper arms. She says " ...it flares up now
every 4-5 hours; with increased heat, and intense itching. Also, it been like this for almost 3 months. XXXXXXX

Answered by Dr. Dr. Rahul Kumar (9 hours later)

Brief Answer:
Photograph required

Detailed Answer:
Hello
Thanks for the follow up.
There are various diseases which present in this form hence photograph is required.
Your description is suggestive of acute urticaria but it doesn't last for months hence bit confusing.
You can even mail me photographs on YYYY@YYYY with subject as ATTN Dr Rahul Kumar.
Please try to send photographs.

Above answer was peer-reviewed by : Dr. Deepak

Follow up: Dr. Dr. Rahul Kumar (5 hours later)

Hi, I have provided some attachments. Please review them.

Answered by Dr. Dr. Rahul Kumar (3 hours later)

Brief Answer:
Contact dermatitis

Detailed Answer:
Hello
Thanks for the follow up and photograph.
It is looking like air borne contact dermatitis.
It is an allergic reaction.
She needs further treatment with steroids.

I think a biopsy has been done.
I can see the suture in photograph.
It will be better to wait for reports.

For instant relief ask her to apply Fluticasone lotion twice daily and give an antihistamine tablet like CETIRIZINE 10 mg Once Daily at bedtime for next 4-5 days..

Let me know if you have any other doubts.
Thank you.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Rahul Kumar (21 hours later)

Thank you! Will try antihistamine and await results of biopsy. She did have an oral
and topical regiment of steroids, with minimal effect. XXXXXXX

Answered by Dr. Dr. Rahul Kumar (1 hour later)

Brief Answer:
Wait for reports

Detailed Answer:
Hello
If steroids are not working other immunosuppressive drugs like azathioprin can be tried.
Let the reports come then we can decide.
Wishing her a good health.
Thank you.

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Dr. Rahul Kumar (21 hours later)

Results of biopsy were "inconclusive". Perhaps its "contact dermatitus"they say, but they are not sure. This has been going on for 3 months! She is rinsing out all her tops and changing laundry soap, just in case. Benedryl helps her sleep, but no effect on rash; its still itches, hurts and every 4-5 hours or so flares up and gets hot. She has told me she had gotten some Fluticasone lotion, earlier on in this thing, and it had minimal to no effect. She is also looking at her diet; food allergy or sensitivity posibility. What is, and how does azathioprin work?

Answered by Dr. Dr. Rahul Kumar (22 hours later)

Brief Answer:
Details below

Detailed Answer:
Hello
Thanks for the follow up.
It's all right, at least she doesn't have lupus.
The biopsy would have shown that.
Following is my advice.
1. To apply Fluticasone lotion in night and plain coconut oil thrice in a day.
2. Take a sedative antihistamine tablet like doxepin 25 mg in night and non sedating antihistamine like fexofenadine 120 mg daily in morning.
3. Tablet azathioprine 50 mg daily.
The above medication should be continued for at least a month to get some response.
Azathioprin is an immunosuppressive drug and is safer than steroids with minimal side effects.
Please meet a dermatologist and get them prescribed.
Let me know if you have any other doubts.
Thank you.

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. Sonia Raina