[30F] Experiencing unexplained rashes and crawling skin sensation

Patient Description

A 30-year-old female has been experiencing red, flat, and raised rashes of various kinds all over her body for the past 4 months. The rashes were initially itchy but now persist without a known trigger or relief. Accompanying these symptoms is a sensation of something crawling on her skin, also present for 4 months, with no identified alleviating factors. The patient reports concurrent fatigue but no fever, systemic symptoms, or respiratory issues. There is no recent travel, known contact with similar symptoms, or new environmental exposures. The patient has no known allergies, adverse reactions to medications, pre-existing conditions, or chronic illnesses. She is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Dermatitis: This is a general term that describes an inflammation of the skin. Dermatitis can have many causes and occurs in many forms. It usually involves an itchy rash on swollen, reddened skin.

    • Treatment typically involves identifying and avoiding any triggers that may be causing your symptoms. Over-the-counter creams and ointments, prescription medications, and self-care measures can help relieve your itching.
  • Psoriasis: This is a skin disorder that causes skin cells to multiply up to 10 times faster than normal. This makes the skin build up into bumpy red patches covered with white scales. They can grow anywhere, but most appear on the scalp, elbows, knees, and lower back.

    • Treatment for psoriasis usually helps to keep the condition under control and may include creams, medications, and light therapy.
  • Scabies: This is an itchy skin condition caused by a tiny burrowing mite called Sarcoptes scabiei. Intense itching occurs in the area where the mite burrows. The urge to scratch may be especially strong at night.

    • Treatment involves medications that kill scabies mites and their eggs.
  • Allergic Reaction: An allergic reaction occurs when cells in the immune system interpret a foreign substance or allergen as harmful. The immune system overreacts to these allergens and causes symptoms such as skin rashes.

    • Treatment involves avoiding known allergens and controlling symptoms with over-the-counter treatment like antihistamines.

Please remember that these are just possibilities and not a definitive diagnosis.

What you can do

  1. Try to identify any potential triggers for your rashes and avoid them. This could include certain foods, fabrics, or substances.
  2. Use a mild, fragrance-free soap for bathing and washing your clothes.
  3. Apply an over-the-counter hydrocortisone cream to the affected areas to reduce inflammation and itching.
  4. Keep your skin moisturized. Dry skin can often make itching worse.
  5. Try not to scratch your rashes. This can lead to further inflammation and possible skin infections.
  6. Seek professional medical advice. A healthcare provider can examine your skin and possibly perform tests to determine the cause of your symptoms.

What you should look out for

Seek immediate medical attention if:

  • Your rashes are spreading rapidly or getting significantly worse.
  • You develop a fever or other signs of an infection, such as pus or increased redness around the rashes.
  • You experience difficulty breathing or swelling of the face, mouth, or throat.
  • Your rashes are causing severe discomfort and are not improved with over-the-counter treatments.

Remember, it's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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11 mo ago

People Also Ask


What are the common causes of persistent skin rashes?

Persistent skin rashes can be caused by a variety of factors including dermatitis, psoriasis, allergic reactions, infections like scabies, or even stress. Identifying the specific cause often requires a medical evaluation.


How can I differentiate between dermatitis and psoriasis?

Dermatitis typically presents as an itchy rash on swollen, reddened skin and can be triggered by various irritants or allergens. Psoriasis, on the other hand, is characterized by red patches covered with white scales and is due to rapid skin cell production. A healthcare provider can help differentiate between the two through examination and possibly skin tests.


What are the symptoms of scabies and how is it treated?

Scabies is characterized by intense itching, especially at night, and a pimple-like rash caused by mites burrowing into the skin. Treatment involves prescription medications that kill the mites and their eggs, and it's important to treat all close contacts and thoroughly clean clothing and bedding.


Can stress or fatigue contribute to skin rashes?

Yes, stress and fatigue can exacerbate skin conditions or trigger flare-ups in some individuals. Managing stress through relaxation techniques and ensuring adequate rest can sometimes help improve skin symptoms.


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