June 5, 2012
Treatments for body rash
Joanne T. has noticed a rash which is just not going away on her 13-year-old son's face and back. He has a light skin rash to areas near his eyebrows and at the corners of his nose. He also has a light-coloured spreading rash on his chest and upper back. Joanne said her son was treated by the doctor with a cream for liver spots, but it has not been clearing up for several months now.
She asked Lifeline to give an opinion and suggest a treatment.
It is never wise to diagnose a skin condition without properly visualising the disorder! In this situation, where there is no response to treatment, Joanne should schedule a follow-up visit with her doctor for review of the management. Alternatively, she could see a dermatologist (skin specialist).
form of eczema
Nevertheless, Lifeline will discuss two skin conditions which could possibly be the problem with this young man. The description of the facial rash could suggest a diagnosis of atopic dermatitis, a form of eczema, while the spreading rash to the trunk could possibly be pityriasis versicolor, popularly known as 'liver spot'. Treatment for the two conditions differs.
Atopic dermatitis is an inherited form of hypersensitivity that often first appears in childhood but canalso affect adolescents. People with this disorder often have other family members with allergies and a history of eczema. This rash can worsen after eating certain food types or after exposure to dust or pollen, in similar fashion to the person with Hay Fever or some forms of asthma.
Atopic eczema can be a chronic disorder which responds to treatment but can recur. This eczema occurs commonly on the face, behind the ears and in the creases of the elbows, knees and groin region. It is not contagious.
This disorder, which is possibly present to the face of Joanne's son, is usually treated with an anti-inflammatory steroid cream or ointment. There are many such useful preparations but not all can be recommended for children. Some common examples are hydrocortisone ointment, Advantan cream, Elocon cream or ointment, and others such as Cutivate, Dermatop, Betnovate and Dermovate. Long-term use is not recommended because of possible side effects. If skin itching is a problem, oral antihistamine preparations are also used.
Often allergies related to citrus fruits, egg, wheat, cow's milk, shell fish and chocolate can also be related to eczema and may need to be eliminated from the diet. Overexposure to sunlight and heat can worsen the rash.
Pityriasis versicolor (or tinea versicolor) is a fungal skin infection that thrives on the outer layers of the skin. It shows often as a blotchy, white (sometimes dark) discolouration of the skin. It can be found anywhere on the skin but is often found on the front or back of the trunk of affected individuals, and tends to spread in an almost sheet-like manner. It can affect large areas of the trunk if left untreated.
Other that the characteristic skin discolouration, it produces few, if any, other symptoms. However, it is difficult to get rid of. Normal colour does not return until the condition is adequately treated and the skin is allowed some sun exposure. Here, topical medication alone does not resolve the problem if it is extensive, and oral medication may also be necessary. It is important to note that all the medication routinely used to treat ringworm (tinea corporis, cruris, capitis ), a close cousin to liver spot, will not necessarily succeed in treating the pityriasis versicolor.
Typically, at this time, successful treatment will involve the following:-
Ketaconazole (Nizoral) shampoo is applied as a soap daily and left on the skin over the affected areas for a few minutes before washing off.
Ketaconazole, Sporonox (or its generic preparations) or Fluconazole can also be taken orally.
Topical antifungal preparations such as Batrafen, Travagen, Canesten or Candid preparations (and there are others) can also be applied topically.
Lifeline hopes Joanne can be guided by our suggestions at this time. She should definitely revisit her physician for follow up!
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