[35F] With itchy and burning bumpy rash

Patient Description

A 35-year-old female presents with a bumpy rash that itches and then burns after scratching. The rash has been present for about a week. The patient has no history of injuries to the affected area and has not been exposed to any new substances such as soaps, lotions, or plants. There is no fever, swelling, or discharge associated with the rash. The patient has a history of allergies to red meat and gluten. She has tried Benadryl, hydrocortisone cream, and cleaning with alcohol, but none have provided relief. There are no other rashes or skin changes on other parts of the body. The patient has not experienced any recent changes in diet, environment, or travel. She is not taking any new medications or supplements. Her medical history includes long COVID, high blood pressure (diagnosed earlier this year), high cholesterol (diagnosed earlier this year), peripheral neuropathy (diagnosed this year), obesity (since 2013), cervical and lumbar stenosis (diagnosed in 2021), and depression.

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Arora's Assessment

Thank you for providing all the necessary information. Based on the symptoms and history you've shared, here's some advice that might help you understand what could be happening and what you can do:

What might be happening

Based on your symptoms of a bumpy, itchy rash that burns after scratching, along with headache, joint pain, upset stomach, and fatigue, here are some possible explanations:

  1. Contact Dermatitis: This is a common skin reaction to an irritant or allergen. Given your history of allergies to red meat and gluten, it's possible that you might have come into contact with something that triggered this reaction.

    • Treatment: Avoiding the irritant or allergen, using topical corticosteroids, and taking antihistamines can help manage symptoms.
  2. Eczema (Atopic Dermatitis): This chronic condition can cause itchy, inflamed skin. Stress and other factors can trigger flare-ups.

    • Treatment: Moisturizers, topical steroids, and avoiding known triggers can help manage eczema.
  3. Psoriasis: This is an autoimmune condition that causes red, scaly patches on the skin. It can be associated with joint pain (psoriatic arthritis).

    • Treatment: Topical treatments, phototherapy, and systemic medications can help manage psoriasis.
  4. Viral Exanthem: Some viral infections can cause a widespread rash along with systemic symptoms like headache, joint pain, and fatigue.

    • Treatment: Symptomatic treatment, such as rest, hydration, and over-the-counter pain relievers, can help.
  5. Drug Reaction: Although you mentioned not taking new medications, sometimes reactions can occur with existing medications.

    • Treatment: Discontinuing the offending drug (under medical supervision) and using antihistamines or corticosteroids can help.

What you can do

  1. Avoid Scratching: Scratching can worsen the rash and lead to infection. Try to keep your nails short and consider wearing gloves at night.
  2. Moisturize: Use a fragrance-free moisturizer to keep your skin hydrated.
  3. Cool Compresses: Applying cool, damp cloths to the affected areas can help soothe itching and burning.
  4. Over-the-Counter Treatments: Continue using antihistamines like Benadryl and hydrocortisone cream, but if they are not effective, consult a healthcare provider.
  5. Track Symptoms: Use MDandMe to journal your symptoms, track progress, and share this information with your healthcare provider.
  6. Avoid Known Allergens: Since you have allergies to red meat and gluten, ensure you are not consuming these or coming into contact with them.

What you should look out for

Seek medical attention if you experience any of the following:

  1. Severe Symptoms: If the rash spreads rapidly, becomes very painful, or shows signs of infection (such as pus, increased redness, or warmth).
  2. Systemic Symptoms: If you develop a high fever, difficulty breathing, or swelling of the face or throat.
  3. Persistent Symptoms: If the rash and other symptoms do not improve with over-the-counter treatments or continue to worsen.

Remember, while this advice can help you manage your symptoms, it is important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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5 mo ago


People Also Ask


What are common causes of a bumpy, itchy rash that burns after scratching?

Common causes of a bumpy, itchy rash that burns after scratching include contact dermatitis, eczema, psoriasis, viral exanthem, and drug reactions. Identifying the specific cause often requires considering recent exposures, medical history, and accompanying symptoms.


How can I differentiate between eczema and psoriasis?

Eczema typically presents as itchy, inflamed skin that may be triggered by stress or allergens, while psoriasis often appears as red, scaly patches and may be associated with joint pain. A healthcare provider can help differentiate between the two based on appearance and symptoms.


What should I do if over-the-counter treatments for my rash are not effective?

If over-the-counter treatments are not effective, it's important to consult a healthcare provider. They can provide a formal diagnosis and may prescribe stronger medications or recommend other treatments such as phototherapy.


Can existing medications cause a rash even if I haven't started any new ones?

Yes, existing medications can sometimes cause a rash even if you haven't started any new ones. This can occur due to a delayed hypersensitivity reaction or changes in how your body processes the medication. It's important to discuss any new symptoms with your healthcare provider.


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