I have had a rash on my right chest for five months. I asked many doctors but no one can say excatly what it is. It is a red small rash without symptoms. I did try some stuff like Hydrocortisone 1% cream for two weeks and an antifungal medicine for two weeks but nothing happened. Then more than a week ago, I did go to the doctor and he prescribed Fusidic Acid and Betamethasone 20mg/g plus 1mg/g cream. I have taken this for one week and three days with one day pause. I have attached few pictures before and after the treatment and the medicines seem to work very well. I want to know should I continue until the symptoms have totally gone or should I use it only once a day instead of twice a day? What is the best option without side effects and long-term complications? If I have to stop these medicines, should I start using Hydrocortisone 1% cream? I have read on the internet that the cream might damage my eyes. Is it true? After I take a shower, is it safe to touch the affected area? Should I be careful when I wash my hair or face after touching the affected area? What can I do to make sure this does not come back after it has gone.
I have reviewed the clinical photographs attached (attachment removed to protect patient identity).
There is an asymptomatic rash. The probable diagnosis can be miliaria with eczematization or fungal infection or pityriasis rosea. Since you have applied antifungal and steroid creams in the past, the clinical picture can get modified. At present, the rash has resolved.I suggest you apply antibacterial and steroid combination cream, Fusidic Acid and Betamethasone once daily for another week and then stop. There is no need to apply the hydrocortisone based cream. There is no need of using steroid based creams for prolonged periods as it can lead to side effects. There can be thinning of the skin, telangiectasia, atrophy of the skin, and acneiform eruptions. A steroid-based cream should not be applied around the eyes as it can lead to glaucoma. Since you are applying this cream over your chest, there is no risk of side effects to organs or eyes. There is no risk if you touch the area while showering and accidentally touch the eye with the same hand after seven to eight hours. If this rash reoccurs then I would advise you get a skin biopsy done for the same. Applying the steroid-based cream is not a solution always.
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