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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Skin Inflammation On Nose

I had an inflamed patch of pink skin on may face on both sides of the nose (on the upper cheeks) and several small pink bumps. This was itchy as well. The doctor prescribed prednisone and it cleared up with that. But the small pink bumps returned after two weeks (although in much milder form) and I seem to have got a few of these now on my neck and shoulders as well. The doctor says this is a bacterial infection and has prescribed an antibiotic now. However, I am concerned whether the diagnosis is right and what could be the real cause and treatment of this problem?
Fri, 27 Mar 2015
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Dermatologist 's  Response
Hello. Thank you for writing to us.

I suggest a possibility of seborrheic dermatitis.
Seborrheic dermatitis can present with itchy, red, scaly patches at various sites including face.
Sides of the nose is a commonly affected site for seborrheic dermatitis and presents with scaly, itchy patches.
Seborrheic dermatitis is a steroid responsive skin condition and responds very well to them.
Steroids are antiinflammatory and thus benefit in this skin condition.
I suggest you to apply a moderately potent topical steroid e.g fluticasone propionate 0.05% cream, twice daily for 2 weeks.
Seborrheic dermatitis can relapse as you must have noticed that the patch have reappeared. Re-treatment may therefore be required.
However since topical steroids cannot be used for more than 2 to 4 weeks on face because of the risk side effects like skin atrophy, acne etc therefore for recurrent disease Or mild relapses I would suggest a topical immunomodulator e.g pimecrolimus cream twice daily.
If your seborrheic dermatitis recurs frequently topical immunomodulators can even be used for maintenance of improvement as they are devoid of steroid related side effects.
The pink bumps that you have developed on neck and shoulders is most likely an acneform eruption to oral prednisolne that was given to you for seborrheic dermatitis patch.

Regards
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Suggest Treatment For Skin Inflammation On Nose

Hello. Thank you for writing to us. I suggest a possibility of seborrheic dermatitis. Seborrheic dermatitis can present with itchy, red, scaly patches at various sites including face. Sides of the nose is a commonly affected site for seborrheic dermatitis and presents with scaly, itchy patches. Seborrheic dermatitis is a steroid responsive skin condition and responds very well to them. Steroids are antiinflammatory and thus benefit in this skin condition. I suggest you to apply a moderately potent topical steroid e.g fluticasone propionate 0.05% cream, twice daily for 2 weeks. Seborrheic dermatitis can relapse as you must have noticed that the patch have reappeared. Re-treatment may therefore be required. However since topical steroids cannot be used for more than 2 to 4 weeks on face because of the risk side effects like skin atrophy, acne etc therefore for recurrent disease Or mild relapses I would suggest a topical immunomodulator e.g pimecrolimus cream twice daily. If your seborrheic dermatitis recurs frequently topical immunomodulators can even be used for maintenance of improvement as they are devoid of steroid related side effects. The pink bumps that you have developed on neck and shoulders is most likely an acneform eruption to oral prednisolne that was given to you for seborrheic dermatitis patch. Regards