Do non-irritant skin rashes on the neck and chest region indicate viral erythematous skin rashes?
Patient's Query
Hi doctor,
I have had this skin rash on my neck and chest for five to six days. At the same time, some cold symptoms like sore throat, minimal fever, nasal congestion, and cough appeared. My skin is sensitive to dairy products, strawberries, and blackberries, but I have not eaten them at all. On the same days, I took some new multivitamins (Supradyn). After I noticed the rash, I stopped taking any medications. I went to the pharmacy where I got an antihistamine, but after two to three days of taking it, the rash is not getting better (in fact, a little worsen). What is the possible cause of these rashes? I have attached the pictures. Kindly give your opinion.
Hello,
Welcome to icliniq.com.
I understand your concern. The lesional morphology of a central papule or vesicle over the background of erythema is suggestive of varicella (attachments removed to protect the patient's identity). Also, you have had prodromal symptoms. Varicella usually does not happen twice in life. So if you have not had varicella or chickenpox before, it is highly likely you have it now. Varicella, though, is not localized only to the neck and chest and usually involves generalized skin surface, also mucosa sometimes. Even if it is varicella, there are not many roles of antivirals so late in the course of it. I would appreciate it if you could send a bit close-up photograph and details if a few lesions are there on other body parts or exclusive to the neck and chest. I hope this was helpful.
Patient's Query
Hi doctor,
Thank you. I had chickenpox in my childhood what I checked with a blood test in 2018 due to pregnancy, and I have an antibody, so that it might be something else. I have retaken some pictures. I hope these are better. In the center of some red spots, there is some yellow substance, as acne. The spots are not itchy or painful, just aesthetically awful. There is in my neck, my chest, and a little at my upper back. (Typical areas for me to have blackheads and acne). My effective acne or blackhead curing cosmetics, like BHA, Niacinamide, or Retinol useless with this rash. Kindly give your opinion.
Hi,
Welcome back to icliniq.com.
Thanks for sharing the pictures (attachments removed to protect the patient's identity). Central pustules and surrounding erythema associated with all those prodromal symptoms still indicate some form of a viral exanthematous rash. You have not applied anything new to these areas, any new cosmetic product, or any cosmetic procedure in the last two weeks or so? Whatever other differential I have, are all itchy conditions. As It feels more like some inflammatory rash rather than an infective one, using a mild steroid cream, which may be in combination with an antibiotic, will help like Fucibet cream (Fusidic acid and Betamethasone) twice a day for four to five days. Any new products or cosmetic procedures in the last two weeks if you have, do let me know in the free follow-up. Otherwise, a viral exanthematous rash is the most probable diagnosis right now. It is not acne, or even acneform eruption, which is induced by some drugs, so anti-acne medicines will not work. I hope this was helpful.
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