How to reduce persistent scales and rashes on my body?

Question

Hello doctor,

I have been suffering from skin rashes all over my body for 8 years. There were various therapies, but none of them helped. Sometimes the rashes are dry and irritating, and the skin peels off like dandruff.

Now I am applying Seclia lotion. I’ve been working in the fragrance sector for the last two months. Is it safe for me to keep working there?

Could you please provide me with appropriate treatment advice? I am also enclosing pictures (attachment removed to protect patient's identity) of the rashes.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Based on your history of long-standing dry, scaly, and sometimes itchy rashes involving much of the body for eight years, and from the image you shared showing diffuse dryness with fine white scaling and superficial flaking without obvious thick plaques, oozing, or sharply demarcated red borders, this most likely suggests chronic xerotic eczema, also known as asteatotic eczema, or chronic dermatitis.

In some patients, chronic plaque psoriasis can also present with dry scaling. However, psoriasis frequently presents as well-defined red plaques with silvery scales that are thicker, especially on the elbows, knees, and scalp.

You are applying glycerin lotion, good for moderate conditions. However, as your illness appears to be moderate with significant scaling, you will require more therapy.

To deal with this, swap soap. Apply a thick emollient (like petroleum jelly or a ceramide-based cream such as Oryza [ceramide, cholesterol, and free fatty acids cream]) at least twice daily and especially after bathing.

It has a 3:1:1 ratio of ceramide, cholesterol, and fatty acids to seal in moisture, minimize irritation, and calm sensitive or injured skin. Avoid very hot water, harsh soaps, and frequent scrubbing.

You may use Methylprednisolone aceponate topical solution 0.1 percent on the flaky areas only at bedtime for 10 to 14 days. Do not use for longer than this. Side effects may occur with prolonged use. One to two weeks of use should be enough to get your situation under control.

If you are in the fragrance industry, you are exposed to perfumes, chemicals, and solvents that can exacerbate dermatitis, especially if you have sensitive or eczematous skin to begin with. Wear protective clothes. Do not allow direct contact of aroma oils with skin. Wash exposed areas gently after work. Apply moisturizer regularly. If you start this job and see it get worse, you may need to patch test to rule out allergic contact dermatitis.

If you are itching, you can take Cetirizine 10 milligrams at bedtime for 3 to 5 days. First, care for your skin barrier. Chronic skin diseases react slowly but surely to the appropriate approach. Stay consistent and do not give up.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.