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Q. I have scaled red rash on my forehead, nose, and chest. Please help.

Answered by
Dr. Shama Naaz
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Apr 29, 2021

Hi doctor,

I have had this scaled red rash for about five weeks. It started on my forehead but has spread to my nose, chest, and my back. I live in the bush with no doctors nearby. I treated it first with Miconazole (fungicide) for a week and noticed no change, following with Quadriderm for a week and observed no change instead, just kept spreading. Next, I treated scabies with Ivermectin and had no change, then went to the town and saw a doctor, and he gave me a course of Tetracycline and Cortisone cream, that was a week ago and still no change. Please help.

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Hi,

Welcome to icliniq.com.

The areas affected are sun-exposed. So there is a possibility of photodermatosis. It will help if you avoid direct sun exposure. And you should apply a broad-spectrum sunscreen with an SPF (sun protection factor) of 30 or higher daily even if you are at home.

There are some questions for you,

1. Are you under any medication that you take daily or have started recently?

2. Do you have any itching or burning sensations?

3. Did you use hair dye before the appearance of rash?

Hi doctor,

I know it looks like sunburn, but it is not. I use factor 50 sunblock when I am out in the sun and a big hat but have not been in the sun since this problem started. Other than that, as mentioned before, I took a course of Bactrim for a bladder infection about six weeks ago. I take Eltroxin 150 mcg per day daily for hypothyroid. Yes, it is itchy but not burning. I have not used hair dye. Initially, it spread to my chest and shoulders about three weeks after it appeared on my forehead and then to my nose, starting with a scab.

#

Hi,

Welcome back to icliniq.com.

Are you currently taking any antihistamines for itching?

Hi doctor,

No, I am not taking anything for the itching.

#

Hi,

Welcome back to icliniq.com.

You should apply Caladryl lotion (Calamine and Diphenhydramine hydrochloride) over the red areas to relieve itching. It will help if you wash your face with a gentle cleanser. And it will be best if you use a hypoallergenic moisturizer like CeraVe facial moisturizer, twice daily. Thank you.

Hi doctor,

Thank you for suggesting the medicines. What do you think this is? Please let me know.

#

Hi,

Welcome back to icliniq.com.

For your short duration red lesions along with scaling, my differential diagnosis is,

  1. Allergic contact dermatitis.
  2. Seborrhoeic dermatitis.

To confirm it, you should get a dermoscopic evaluation and an allergy test done. Thank you.


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