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What does itchy rash on breast spreading to neck indicate?

Jan 2014
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Practicing since : 2002
Answered : 7385 Questions
My mom has this rash it started on her breast and now is spreading on her neck. Not warm to touch...but very itchy.
Posted Sat, 22 Mar 2014 in General Health
Answered by Dr. Kakkar S. 1 hour later
Brief Answer: Dermatitis Detailed Answer: Hello and Welcome to Healthcaremagic I am Dr. Kakkar and I would help you with your concern. Seems to me a case of either Allergic contact dermatitis OR Xerosis with Xerotic Eczema/Dry Discoid Dermatitis probably exacerbated OR precipitated by irritation to clothes (? woolens). I would like to gather some more information from you in order to be able to help you better. --How old is she? Does she have a dry skin? --Since how long has the rash been present?Is it present on both the sides? --Is it scaly? If I was the treating doctor, I would have asked you to use a good moisturizing cream twice daily followed by application (after a gap of 15-20min) of a moderately potent topical steroid e.g mometasone or fluticasone over the rash, twice daily. An OTC antihistamine e.g cetrizine or loratadine once or twice daily would help in relieving the itch. regards
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Follow-up: What does itchy rash on breast spreading to neck indicate? 26 minutes later
She is 76 yrs old. Dry skin due to weather. Has had on breast for 3/4 weeks and now is on neck. Not scaly. Present underneath both breast and just on left side of neck.
Answered by Dr. Kakkar S. 58 minutes later
Brief Answer: First rule out fungal infection... Detailed Answer: Hi. Thanks for the additional details. The distribution of the rash beneath the breasts(in the folds), as you say, throws another possibility of a fungal infection. Fungus thrives in moist body folds like groins, sub-mammary folds, axilla etc. The best way to approach this is to get a KOH scrapping from the rash to look for fungal infection. If it comes out to be +ve, it is definitely fungal. Negative result rules out fungus and leads us back to the previous diagnosis If the rash in the sub-mammary folds does turn out to be fungal, you can ask her to use a topical antifungal cream like clotrimazole twice daily for 4-6 weeks. An oral antifungal e.g Fluconazole can also be added for faster results. One the infection is cured, an Antifungal dusting powder can be used regularly to keep the area dry and unfavourable for fungal growth. regards
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