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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Psoriasis With Breast Rashes, Cuts And Redness Be Treated?

i have had psoriasis for 30 years.. i am large breasted and have worn underwire bras for 30 years.. i have had a red rash and cuts, slice like cuts under my breasts, when i lived near the ocean i could control the rash, but i have lived away from the ocean for 6 years and the rash is worse and just seems to be getting larger, it is bright red, i have been told my doctors it is fungus, it is nickel allergy from the underwire, i have been given lotions and creams, nothing works, the rash is on the under side of my breast, in the crease of my breast and on my trunk, any ideas, is it nickel, or steel in the underwire, or fungus, i'm looking desperately for a company that makes strong support bras without wires.
Thu, 9 Apr 2015
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Dermatologist 's  Response
Hello. Thank you for writing to us

I suggest a likely possibility of fungal infection/ intertrigo Or it could also be intertriginous psoriasis considering that you have a history of psoriasis.
Body folds like sub-mammary area, groin etc trap moisture and warmth and therefore provide an Ideal environment for the fungus to grow.
Psoriasis too can affect body folds and presents as bright red patches with lot of itching and burning sensation.
If I was the treating doctor I would have started you empirically on a topical antifungal+steroid combination cream e.g clotrimazole 1%+beclomethasone dipropionate 0.025% cream, twice daily.
The steroid part would take care of the inflammation i.e itching and redness whereas the fungal part would help control the fungus.
Moreover intertriginous psoriasis is a steroid responsive condition and topical steroids are drugs of choice for intertriginous psoriasis.
Since the affected area is quite large therefore I would also suggest an oral antifungal e.g fluconazole.
An OTC oral antihistamine e.g cetrizine 10 mg once daily will provide you symptomatic relief from itching.
Topical and oral antifungals need to be continued for 4-6 weeks.

Regards
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How Can Psoriasis With Breast Rashes, Cuts And Redness Be Treated?

Hello. Thank you for writing to us I suggest a likely possibility of fungal infection/ intertrigo Or it could also be intertriginous psoriasis considering that you have a history of psoriasis. Body folds like sub-mammary area, groin etc trap moisture and warmth and therefore provide an Ideal environment for the fungus to grow. Psoriasis too can affect body folds and presents as bright red patches with lot of itching and burning sensation. If I was the treating doctor I would have started you empirically on a topical antifungal+steroid combination cream e.g clotrimazole 1%+beclomethasone dipropionate 0.025% cream, twice daily. The steroid part would take care of the inflammation i.e itching and redness whereas the fungal part would help control the fungus. Moreover intertriginous psoriasis is a steroid responsive condition and topical steroids are drugs of choice for intertriginous psoriasis. Since the affected area is quite large therefore I would also suggest an oral antifungal e.g fluconazole. An OTC oral antihistamine e.g cetrizine 10 mg once daily will provide you symptomatic relief from itching. Topical and oral antifungals need to be continued for 4-6 weeks. Regards