[37F] With persistent rash, severe itching, and insomnia

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

• Eczema (Atopic Dermatitis): Eczema is a chronic condition that causes the skin to become inflamed, itchy, and red. It can be triggered by various factors, including stress, allergens, and irritants. The severe itching and rash spreading to different parts of your body could be a sign of a flare-up.

  • Treatment: Eczema is typically managed with topical corticosteroids, moisturizers, and antihistamines to control itching. Your doctor has prescribed fluocinolone acetonide, which is a topical corticosteroid, and other medications like Xyzal and Doxepin to help with itching and sleep.

• Scabies: This is a skin infestation caused by tiny mites that burrow into the skin, causing intense itching and a pimple-like rash. The fact that your doctor is treating you prophylactically for scabies suggests this could be a consideration.

  • Treatment: Scabies is treated with prescription creams and lotions that kill the mites. Oral medications like Ivermectin can also be used.

• Contact Dermatitis: This is a skin reaction that occurs after exposure to an irritant or allergen. Given that you have been using multiple topical treatments, it's possible that one of these could be causing a secondary rash.

  • Treatment: Identifying and avoiding the irritant or allergen is crucial. Topical corticosteroids and antihistamines can help manage symptoms.

• Drug Allergy: The appearance of a rash similar to one caused by an ibuprofen allergy and the fact that you have been using ibuprofen for swelling suggests a possible drug allergy.

  • Treatment: Discontinuing the suspected drug (which you have done) and using antihistamines and corticosteroids to manage symptoms.

What you can do

1. Follow Up with Your Doctor: Given the severity and persistence of your symptoms, it's essential to keep your healthcare provider informed. They may need to adjust your treatment plan or perform additional tests to identify the cause of your rash.
2. Avoid Known Irritants: Since you suspect ibuprofen might be contributing to your symptoms, continue to avoid it and monitor your skin's response.
3. Moisturize Regularly: Keeping your skin well-moisturized can help manage eczema symptoms. Use fragrance-free and hypoallergenic moisturizers.
4. Cool Compresses: Applying cool, damp cloths to the affected areas can help soothe itching and reduce inflammation.
5. Hydration and Nutrition: Ensure you are staying hydrated and eating a balanced diet to support your skin health.

What you should look out for

Seek immediate medical attention if you experience any of the following:

• Signs of Infection: Increased redness, warmth, swelling, or oozing from the rash could indicate an infection.
• Severe Allergic Reaction: Swelling of the face, lips, or tongue, difficulty breathing, or a rapid spread of the rash could be signs of a severe allergic reaction.
• Uncontrolled Symptoms: If the rash continues to spread, becomes more painful, or if you are unable to manage the itching and discomfort, you should seek medical care.

Remember, while I can provide information based on your symptoms, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment.