Is this really atopic dermatitis?

[dimage]

I have two rashes on my face just above the lips. Both are mostly symmetric to each other. When the rashes become less visible on some days, they leave a crust of skin.

I also have other skin problems, such as scalp and anal itching. Also, the skin above my lips and on my chin looks very graying and I'm developing warts (have two since my skin problems started).

My doctor says the rashes are an eczama and due to atopic dermatitis. But it looks very ugly, and of course my self confidence is very low right now. I need to find out what is really causing this and what I can do about it.

I've made some pictures and could email them to you so you can see for yourself. Please let me know how I can do this. I can't expect  you to tell me what's the cause and what to do about it by only giving you a textual description of my problem.

Maybe you can enhance the web site such that people can upload pictures?

[Alan Rockoff, MD]

Atopic dermstitis (eczema) isn't caused by anything--it's a hereditary sensitivity which falres up here and there for no special reason.  I assume that your docotr doesn't think there's anythin you're allergic to in particular.

I'm puzzled when you ask whether there is anything to do about it.  Didn't the doctor who made the diagnosis make any suggestions?

Most of the time steroid (cortsione) creams are recommended and they help a great deal, at least to quiet down the condition and make it look presentable.

If whatever the doctor prescribed isn't working--or if you're scratching and can't stop--you should ask the doctor for a different treatment.

Best.

Dr. Rockoff

[dimage]

Well, it never really goes away. I have some cremes that make it better, but they contain antibiotics to stop the inflammation.

I'm worried because it is chronic. Even when I apply the creme, the inflammation is reduced but still shows, although not that severly. And my skin tone has become very gray in some areas. It makes my skin look dirty. I also have this uncomfortable somwhat itchy feeling all over my body for a long time; not itcy enough to scratch, but itchy enough to be uncomfortable.

Before I had the rash in my face I had this itchy feeling all over my body. I went to see a doctor, but he found nothing wrong with my skin. So he told me that there's nothing wrong with me. Now that I got these rashes in my face last year, I was somewhat relieved, figuring a doctor could tell me what's wrong and how to fix it. But now it seems that the diagnosis is a subtle "atopic" dermatitis and that there is no cure, just some cremes to keep the inflammation down. I'm not happy with that. Still hoping that it could be something else. That's why I turn to you. I would like to get feedback from more than one doctor. Maybe you can say "it's possible that the reason for the rashes is ...." and you can take this test ... to find out."

So, can I send you some pictures for you to comment on? I can't expect you to give me answers if you don't see it for yourself. I also don't have much confidence in your evaluation of the diagnosis if you do not think it is worthwile to look at the pictures.

Thx

[Alan Rockoff, MD]

Most rashes can be suppressed but not cured.  The distribution of the rashes you list does suggest atopic dermatitis rather than an allergy.

I don't think pictures would help me give you the level of confidence you currently lack.  My suggestion is that you show a live physician, but that you be prepared for a repetition of the diagnosis.

Dr. Rockoff