[20F] Experiencing underarm rash

Patient Description

A 20-year-old female is experiencing a large, red, itchy rash under both arms for approximately 4 days. The rash has not responded to any attempted relief measures. The patient's medical history includes celiac disease, postural orthostatic tachycardia syndrome (POTS), and a mast cell disorder, all diagnosed in 2019. Additionally, the patient has a known allergy to heparin and a history of allergic dermatitis. Current medications include Zoloft, Zofran, Zyrtec, Allegra, Lo Estrin, Corlanor, Periactin, and Pepcid. There are no other symptoms or medications reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, the possible causes of your underarm rash include:

  • Allergic Contact Dermatitis: This is a skin condition where the skin becomes red, sore, or inflamed after direct contact with a substance. Given your history of allergic dermatitis and the fact that the rash is localized to your underarms, this could be a reaction to a new deodorant, soap, or laundry detergent.

    • Treatment usually involves avoiding the substance that caused the reaction, and applying creams or ointments to soothe the skin.
  • Intertrigo: This is a rash that usually occurs due to the chafing of warm, moist skin in the folds of the body. Your underarms are a common place for this to occur.

    • Treatment usually involves keeping the area dry and applying topical creams.
  • Mast Cell Disorder Flare: Given your history of mast cell disorder, it's possible that this rash could be a symptom of a flare. Mast cells can release histamine, which can cause itching and redness.

    • Treatment usually involves managing your mast cell disorder, which could include antihistamines and other medications.

What you can do

While waiting to see a doctor, here are some things you can do:

  1. Try to identify and avoid any new substances that may have come into contact with your underarms, such as new deodorants, soaps, or laundry detergents.
  2. Keep the area dry and clean.
  3. Over-the-counter creams or ointments may help soothe the skin.

What you should look out for

You should seek immediate medical attention if:

  • The rash spreads or becomes more severe
  • You develop other symptoms such as fever, difficulty breathing, or swelling
  • The rash does not improve after a few days of self-care

Please remember, while I strive to provide accurate information, I'm not a doctor and this advice is not a substitute for professional medical advice. You should consult with a healthcare professional for a formal diagnosis and treatment.

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11 mo ago

People Also Ask


What is allergic contact dermatitis and how can it be treated?

Allergic contact dermatitis is a skin reaction that occurs when the skin comes into contact with an allergen, causing redness, itching, and inflammation. Treatment typically involves avoiding the allergen and using topical creams or ointments to reduce inflammation and soothe the skin.


What is intertrigo and what are common treatments for it?

Intertrigo is a rash that occurs in skin folds due to friction, moisture, and heat. It is common in areas like the underarms. Treatment involves keeping the area dry, using barrier creams, and sometimes applying antifungal or antibacterial creams if an infection is present.


How can a mast cell disorder cause skin rashes?

A mast cell disorder can cause skin rashes because mast cells release histamine and other chemicals that lead to itching, redness, and swelling. Managing the disorder often involves using antihistamines and other medications to control these symptoms.


What should I do if my rash does not improve with self-care?

If your rash does not improve with self-care, you should seek medical attention. A healthcare professional can provide a proper diagnosis and recommend treatments, especially if the rash spreads, becomes more severe, or is accompanied by other symptoms like fever or difficulty breathing.


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