No dx for weird rash

[Joe1432]

Hi doctor,

I hope that my main question does not have too broad of a response that you cant answer it-- I have been under a lot of stress because of this mysterious rash (amongst other things!).

Main Question:
What are all of the common and not so common diseases or ailments that can manifest as a rash. (I know there are many but I am most concerned of the ones with more serious implications.)

My friend, a 19 yr old female has had a reccurent rash for a month now.  The rash is randomlly dispersed (leg, torso, chest--- but no face) and seems to begin as red bumps (2cm) and then slowly flatten down into dry/red patches (2cm -> fingernail sized).

Some are not symetrical.

At first there were about 20 (randomly dispersed). Yet most faded, but as some fade, others present themselves. Now there are only about 4 new ones.

Her diagnoses and results (from diff. docs) are as follows:

1. "Stress induced excema"   -  rx: Topical Corticosteriod-Result: white scars where the bumps were, then more bumps in other places.

2. "Allergic Hives"  - rx: allegra - some "hives" went down, others arose.

3. (Final) "Persistent Strep infection" - rx: none (not severe enough for antibiotics)

She used "essential oils" from the net, only in one area, is that enough to spark this response? Is the final diag. possible?

Thank you so much doctor.

[Alan Rockoff, MD]

I am skeptical that what your girlfriend has is molluscum--lots of other minor bumps can look like that.  I suggest another opinion.

Dr. Rockoff

[Joe1432]

Doctor if I may add a question...

I have had molluscum removed from my face in the reigon where I shave. Other spots have continued to appear (not many) despite my multiple visits to the derm. Everytime I go they are removed by liquid nitrogen.

My girlfriend got one on her cheek... yet her derm said that she would not remove it, nor would my girlfriend find a doctor that would.

The growth is small, but in the middle of her cheek. Is the scarring bad enough that even if she wanted it removed badly, that a doctor would not do so????? And if so.. how come my doctor has been freezing not only the molluscum but also areas that are only suspected to possibly be a molluscum-in-progress?????

THANK YOU FOR YOUR TIME!

[Alan Rockoff, MD]

Your main question is, I'm afraid, far too general to answer.  Recurrent rashes of the general description you provide my be in the eczema or hive family.  Eczema is often hereditary though people may not know that other family members have or had it), whereas hives almost never have a specific cause.  Neither condition is usually environmentally-induced (diet, detergents, etc.)

I don't know what to make of "persistent strep infection," nor do I think that essential oils would cause a rash.

Taking antihistamines and waiting the rash out would seem to be the best approach.  Most such rashes don't have particular causes, but they don't signify much and usually go away on their own.

For further diagnosis, she'll need to speak with a doctor in  person, perhaps one of those she already consulted.

Best.

Dr. Rockoff

[Joe1432]

I forgot to mention that she had mono a few weeks prior, and has had an elevated lymphocyte count on the CBC for some time now (months). Thank you again.