How to get rid of recurring eczema?

Question

Hello doctor,

I am a 69-year-old female, I weigh 152 pounds and my height is 5 feet 9 inches. I was diagnosed with atopic eczema two months ago and was treated with steroid cream. This has improved but I have had two bouts of athlete's foot, one was infected and I had antibiotics. Now, I have some small raised areas on my legs, arms, shoulders, and hands. It was not itchy initially but now it is. It does not seem the same as previous eczema. Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern. It appears to be erosive pemphigus foliaceous. Please answer the below questions to arrive at a definitive diagnosis:

1 Do you have a fever?

2 What is your drug history?

3 What is your drug history atrophy?

4 Do you have difficulty breathing?

5 Do you have oozing?

Kindly revert back with the answers.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Thank you for the follow-up query.

I can understand your concern. Differential diagnoses are atopic dermatitis, scabies, and vesiculobullous disorder (autoimmune disorder) with a secondary bacterial infection. I would suggest you clean the area with a Povidone-iodine solution and a cotton gauze piece twice daily for two weeks. Do not worry, it is a benign condition of long duration. Supportive therapy is needed, and local skin care of lesions is of utmost importance. Daily bathing with Ketoconazole Cetrimide soap or Permethrin soap is essential to maintain proper hygiene. Apply Fluticasone Propionate and Mupirocin ointment twice daily for two weeks. Consult your specialist doctor, discuss with him or her, and take the medicines with their consent.

Additionally, do not scratch or rub the lesions. Keep checking on sugar levels, monitor pulse rate and blood pressure, and get routine blood workups done. Also, answer the below questions for further treatment details.

1 What are the possible triggers? Stress, heat, sun, or certain harsh topical creams?

2 Since when did it appear?

3 Was there any similar episode in the past?

4 Are there any similar complaints in the family or partner?

5 Is there night aggravation of itching?

6 Is it tender to touch?

7 Is itching present?

8 What is your occupation?

9 Are you a known case of diabetes?

Thank you.

Answer 3

Hello,

Welcome back to icliniq.com.

Thank you for the follow-up query,

As per your above-mentioned history, it appears to be scabies in clean. The presence of acute onset, pruritus usually sparing the face in adults with nocturnal exacerbation, similar complaints in close contacts, and typical distribution of excoriated papules suggest a diagnosis of scabies with a papular urticarial rash. I would suggest you take the following measures:

Apply betamethasone and fusidic acid cream at night for seven days(on lesions).

Use Cetrimide soap or Permethrin soap soap for bath for two months.

Keep fingernails short.

Wear loose comfortable thin cotton clothes.

Use an air conditioner in summer.

Showering or bathing in cool and lukewarm water, as hot water can be drying.

Do not scratch or rub the lesion.

Apply 5% Permethrin cream on day one and day seven (repeat next week).

Take tablet Ivermectin 12 mg once a week for two weeks.

Maintain proper hygiene as hygiene plays a very important role in avoiding recurrence or remission and Relapse.

I hope this helps you.

Thank you.