Kindly suggest management of recurrent rashes in the neck.

Question

Hi doctor,

My father is 63 years old and has rashes on his neck. He had a rash before and got medication from a family doctor (a steroid and Zantac). He is also taking allergy medication. Since then the previous rash subsided. Now that he completed his 30-day prescription, he got another set of rashes and has irritation, burning sensation, and redness. Can you prescribe for his symptoms?

Answer 1

Hello,

Welcome to icliniq.com.

I have examined the pictures as well as the details sent by you (attachment removed to protect patient identity). I find a similarity of the condition with irritant dermatitis complicated by steroid dependence.

Had I been able to examine him in person, I would have asked him about the evolution of the rash and other details. I believe his original picture has been modified with the use of steroids and he has developed a dependence on this class of drugs. This is clear from the fact that after completion of the 30-day course, he again started having the symptoms. He can be relieved of his problem but we will have to proceed in a systematic manner.

In this case, I recommend the use of either mild or moderately potent steroid creams with the intent to control the acute episode and gradually taper them off to a point where he can stay normal without steroids. I suggest using Mometasone or Betamethasone creams initially and slowly diluting them with cold cream to reduce their potency. Then I suggest increasing the proportion of cold cream till you can control the rash just with cold cream. All this while I suggest depending on antiallergics like Levocetirizine or Desloratadine.

In such a situation, cold compresses are a great help. Just ensure that he does not have any factor that could aggravate his problems like diabetes or other contact allergies. I am sure by following the recommendations, your dad would soon be in his comfort zone.

I hope this helps you.

Take care.