How do I manage a chronic, red, itchy coin-shaped rash?

Hello,

Welcome to icliniq.com.

I understand how frustrating and uncomfortable a chronic itchy rash can be, especially when it worsens with heat and showering.

Based on the history and the image (attachment removed to protect the patient’s identity), this appears to be a chronic inflammatory rash with reddish to dusky patches, mild flaking, itching, and a burning sensation. There are no visible blisters, which is helpful information. The pattern and symptoms suggest a few possible differentials, including nummular eczema, irritant or allergic contact dermatitis, intertrigo with secondary irritation, or, less commonly, a superficial fungal infection (though the absence of a clear active border makes this less likely). Heat and water aggravation strongly point toward an eczema-type process.

For now, gentle skin care is very important.

• Avoid hot showers and excessive washing, as heat can worsen inflammation and itching.

• Clean the area with lukewarm water only, avoid soaps or fragranced products, and pat dry gently.

• Apply plain petroleum jelly in a thin layer two to three times daily to help repair the skin barrier and reduce irritation.

• For itch control, you may take Cetirizine 10 milligrams at night, which can help relieve itching and also improve sleep if the itch is disturbing you.

• Apply Calamine lotion to soothe the burning sensation.

Please avoid scratching, tight clothing, and anything that causes sweating or friction over the area. If possible, can you please share a close-up picture of the affected area, as the margins are not very much visible in this picture, and that will help in diagnosing discoid eczema versus fungal infection? Also, try to take one to 2 pictures with a flashlight and without a flashlight.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.