[53F] Experiencing persistent itchy rash and red spots

Patient Description

A 53-year-old female has been experiencing an itchy rash in the armpit area and red spots on the abdomen for the past four months. The itching is on and off, described as moderate, with slight scaling or flaking of the skin. The rash began as a circular spot on the upper arm and has spread, with the original spot fading and new ones appearing. A distinct red spot on the abdomen has been slowly growing for a month but does not itch. The patient has tried both over-the-counter and prescription antifungal treatments with limited success. There is no history of travel, exposure to new environments, or contact with individuals with similar symptoms. The patient's medical history includes prediabetes, obesity, polycystic ovary syndrome (PCOS), and stage 1 hypertension. She is not currently on any medications and has no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you provided, the following conditions could be possible:

  • Fungal Infection: Despite the lack of response to antifungal treatments, a persistent fungal infection such as ringworm could still be a possibility. These infections can cause itchy, red, and scaly rashes that can spread to different areas of the body.

    • Treatment typically involves topical antifungal creams. If these are ineffective, oral antifungal medications may be necessary.
  • Psoriasis: This is a chronic skin condition that can cause red, itchy, and scaly patches of skin. It's not typically associated with the spreading pattern you described, but it can present in various ways.

    • Treatment can involve topical treatments, light therapy, and systemic medications.
  • Dermatitis: This is a general term for inflammation of the skin, which can cause an itchy rash. It could be contact dermatitis, caused by skin contact with a substance that causes an allergic reaction or irritation.

    • Treatment typically involves identifying and avoiding the irritant, along with topical creams to reduce inflammation and itching.
  • Eczema: A condition that makes your skin red and itchy. It's common in children but can occur at any age. Eczema is long-lasting and tends to flare periodically.

    • Treatment for mild cases typically includes over-the-counter (OTC) products like hydrocortisone 1% cream or prescription creams and ointments containing corticosteroids.

Please note that without a physical examination and possibly further testing, it's difficult to accurately diagnose your condition.

What you can do

Here are some general suggestions that might help alleviate your symptoms:

  1. Avoid scratching the affected areas, as this can worsen the rash and potentially lead to infection.
  2. Try to identify any potential triggers for the rash, such as new products (soaps, detergents, lotions), fabrics, or environmental factors.
  3. Keep the affected areas clean and dry.
  4. Apply an over-the-counter cream for itch relief, such as one containing hydrocortisone, unless you have been advised otherwise by a healthcare provider.
  5. Consider trying an over-the-counter antihistamine to help with the itching.

What you should look out for

You should seek immediate medical attention if:

  • The rash spreads rapidly or covers a large area of your body.
  • You develop other symptoms, such as fever, joint pain, or swelling.
  • The rash becomes painful or starts to ooze.
  • The rash doesn't improve after a few weeks, despite home treatment.

Please remember that while I strive to provide accurate and helpful information, I am an AI and not a substitute for professional medical advice. Always consult with a healthcare provider for accurate information.

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9 mo ago


People Also Ask


What are the common symptoms of a fungal infection like ringworm?

Common symptoms of a fungal infection like ringworm include red, itchy, and scaly patches that may form a ring-like pattern. The rash can spread to different areas of the body and may cause discomfort.


How can psoriasis be differentiated from other skin conditions?

Psoriasis can be differentiated from other skin conditions by its characteristic red patches covered with silvery scales. It often appears on the scalp, elbows, and knees, and can be associated with joint pain in some cases.


What are some common triggers for dermatitis?

Common triggers for dermatitis include contact with irritants or allergens such as certain soaps, detergents, fragrances, and fabrics. Environmental factors like dry air or stress can also trigger dermatitis.


What are effective treatments for eczema?

Effective treatments for eczema include moisturizing the skin regularly, using topical corticosteroids to reduce inflammation, and avoiding known triggers. In some cases, prescription medications or light therapy may be necessary.

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