Pt is a 23 yo Caucasian male presenting with a rash over the entirety of his back with blotchy concentration on the lateral area over the latissimus dorsi and solid concentration over the shoulder area. The rash is red in nature, does not itch, is not raised. The severity comes and goes without known cause, but remains constantly. Presentation began 2 months ago and has increased in severity since.
Pt has no known food or drug allergies. Pt is not taking any prescription medication or recreational drugs; however, he has just finished a prednisone dose regiment. Pt consumes alcohol weekly. No significant change in diet. Pt works out 6 to 7 days a week with an average of 12 hours weekly. He swims 3 days a week, lifts weights 2 days a week, runs 3 to 4 days a week and cycles 3 days a week. The rash is usually worse post exercises, but has flare ups without strenuous activity.
Antibiotic cream and hydrocortisone cream were applied without significant changes in presentation.
Well, without a clinical evaluation it would be difficult to determine the precise cause of the rash. Likely possibilities that may need to be considered include folliculitis, infections, inflammation, allergies etc. I would suggest keeping the region clean and oil and sweat free at all times. Avoid using a talc and try using a mild soap for bathing. Ointments containing benzoyl peroxide/ clindamycin may also be beneficial. If you do not observe any improvement with the mentioned measures, I would suggest consulting a dermatologist for an accurate diagnosis and appropriate management.
Hope this is helpful.
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