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What does severe itching on the arms, stomach and scrotum indicate despite taking Benadryl and Prednisone?

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Posted on Thu, 4 Oct 2018
Question: Hi, I'm a fifty year old male in general good health no meds, or known allergies. Started feeling itchy on my forearms and my stomach, chest, and scrotum about two weeks ago with out any obvious signs on the skin. I took Benadryl and a prednisone pack (4mg, gradual dosing) that did not seem to make much of a difference. Also got a rx for atarax and elocone .1% ointment as directed, with minimal results. By week three just started showing some fine bumps or a few individual red pin point like spots, upper back too now. Itching is worse at night and wakes me up itching. A recent blood test was normal with very slightly elevated MCH and 104 glucose. Any ideas?!
doctor
Answered by Dr. Dr. Kakkar (1 hour later)
Brief Answer:

Regarding generalized itching and spots

Detailed Answer:

Hello,

Perhaps you have either scabies or Xerosis of the skin. Scabies may affect all these areas and is itchier at night.

I suggest you take an empirical treatment for scabies - 2 doses of 12 mg oral Ivermectin, a week apart. In addition, I suggest you apply a 5% Permethrin cream, neck downwards and leave it overnight for at least 8 hours.

You may also take an oral antihistamine e.g Cetirizine tab once every evening for symptomatic relief from itching.

Use a moisturizer regularly and continue with Elocon ointment, twice daily for the red spots.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. Kakkar (3 days later)
Hello Dr Kakkar, since the last time you emailed me and the picture I sent, the break outs are more severe and more in numbers! Here's a follow up picture please advise.
ps I'll send the picture with another email subject Re:[#0000]
Thank you for your attention
Reza
doctor
Answered by Dr. Dr. Kakkar (4 hours later)
Brief Answer:

I suggest that you be started on oral steroids

Detailed Answer:

Hello,

The rash definitely seems flared up in the image of your neck and face.

In addition to what I had already suggested I would suggest a course of an oral steroid e.g prednisone for a few days. At least 10-14 days.

Continue with the moisturizer and Elocon (mometasone furoate 0.1 %) cream, twice daily. Also, continue with Cetirizine tablet for itching.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (16 hours later)
Hello, I did take the ivermectin 12mg, Sulfer soap and the 10% cream,
applied the 5%permethrin as directed. But it pretty much the same !
I know the Prednisone will help but what is the cause? Can we rule out
A bug/mite of sort or fungal infection? Is it contagious? I appreciate your response.
Thank you
doctor
Answered by Dr. Dr. Kakkar (22 hours later)
Brief Answer:

Oral steroids

Detailed Answer:

Hi,

It seems like eczematous dermatitis which could be related to underlying atopic diathesis.

It is not contagious. Dry, cold weather and skin dryness could have precipitated eczema.

Scabies was a possibility and you have been adequately treated for it.

A short course of oral steroids is definitely required and would be effective.

Hope I have answered your query.

Take care

Regards,
Dr Kakkar S., Dermatologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Dr. Kakkar

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What does severe itching on the arms, stomach and scrotum indicate despite taking Benadryl and Prednisone?

Brief Answer: Regarding generalized itching and spots Detailed Answer: Hello, Perhaps you have either scabies or Xerosis of the skin. Scabies may affect all these areas and is itchier at night. I suggest you take an empirical treatment for scabies - 2 doses of 12 mg oral Ivermectin, a week apart. In addition, I suggest you apply a 5% Permethrin cream, neck downwards and leave it overnight for at least 8 hours. You may also take an oral antihistamine e.g Cetirizine tab once every evening for symptomatic relief from itching. Use a moisturizer regularly and continue with Elocon ointment, twice daily for the red spots. Hope I have answered your query. Let me know if I can assist you further.