Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Dermatology (Expert Forum)
PERSISTENT FACIAL ECZEMA RASH
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.
PERSISTENT FACIAL ECZEMA RASH
by nukeraf, Nov 04, 2003 12:00AM
Dear Doctor,
I am a 26 year old white male, with a healthy weight/height, in reasonably good shape. For almost a year now I have had really strange (strange to me) skin issues. I came back home from vacation with a fever of 105. I had been outdoors alot at various times of the day/night over the Thanksgiving holidays in rural Mississippi. My Doctor prescribed a Zithromax antibiotic pack and instantly I reacted with near anaphalctic shock. I returned to the doctor with a full body rash of spots all over; in my eyes, on my face & in my mouth. They didn't itch & were not painful. My internist told me I had an allergic reaction to the Zithromax. I was diagnosed with bronchial pneumonia and recovered. 2 weeks later I shave my arms, and torso area, and developed a horrible infection on both forearms elbow to hand. This eventually went away but not until after a shot of DECADRON & a steroid pack. I was diagnosed with eczema on the arms, & given topical treatments that have worked well. Since then a multitude of things that I was never allergic to before, make my skin react. For the past several months I have developed raised, small red spots that do not itch between my eyebrows, on my eyelids, forhead, all around the mouth area, & at the outer corners of my eyes. I am very conscious of not touching my face, & have been diagnosed with contact dermatitis,w/ my dermatologist blaming my 3 year old black lab as the culprit. I'm not concerned about the forarm eczema, be/c that go's away almost instantly with Elidel. I was instructed to apply Elidel 2X daily to my affected facial areas. At 1st this worked, now it hardly works. It is very red & always irritated. I use soapfree cleansers on my scalp & face. In the morning when I get up, it's totally gone. But as soon as I shower in the a.m. its back. I've experimented w/ not washing my hair or face & it still persists. Elidel is the last in a long line of treatments: Bactroban, .05% Cutivate Cream, Desitin, Hydrocortisone etc. To me, this seems more RASHY than it does Eczema. Is there a possibility all of this being a fungal infection? Sometimes it will totally just go away for a few days, before returning almost instantly & fully. I'm using nonallergy detergents, nonallergy pillows, good bedding, not letting my dog on the bed, etc. I feel like I have crossed all my t-'s & dotted my i's with this, and I still keep having the facial rash. My doctor & dermatologist have not done skin scrapings & insist it is contact dermatitis. I have never had skin problems until after having the allergic reaction to the Zithromax antibiotics. One footnote. I have been living in Montana serving in the military until a year ago. My Dr. thinks the change in environments moving back home to Texas have been a factor in my facial rash/eczema. But since I've had so many inccoculations I am worried I might have Stevens Johnson Syndrome. I've been tested for HIV,w/ a neg result. Please advise.
I am a 26 year old white male, with a healthy weight/height, in reasonably good shape. For almost a year now I have had really strange (strange to me) skin issues. I came back home from vacation with a fever of 105. I had been outdoors alot at various times of the day/night over the Thanksgiving holidays in rural Mississippi. My Doctor prescribed a Zithromax antibiotic pack and instantly I reacted with near anaphalctic shock. I returned to the doctor with a full body rash of spots all over; in my eyes, on my face & in my mouth. They didn't itch & were not painful. My internist told me I had an allergic reaction to the Zithromax. I was diagnosed with bronchial pneumonia and recovered. 2 weeks later I shave my arms, and torso area, and developed a horrible infection on both forearms elbow to hand. This eventually went away but not until after a shot of DECADRON & a steroid pack. I was diagnosed with eczema on the arms, & given topical treatments that have worked well. Since then a multitude of things that I was never allergic to before, make my skin react. For the past several months I have developed raised, small red spots that do not itch between my eyebrows, on my eyelids, forhead, all around the mouth area, & at the outer corners of my eyes. I am very conscious of not touching my face, & have been diagnosed with contact dermatitis,w/ my dermatologist blaming my 3 year old black lab as the culprit. I'm not concerned about the forarm eczema, be/c that go's away almost instantly with Elidel. I was instructed to apply Elidel 2X daily to my affected facial areas. At 1st this worked, now it hardly works. It is very red & always irritated. I use soapfree cleansers on my scalp & face. In the morning when I get up, it's totally gone. But as soon as I shower in the a.m. its back. I've experimented w/ not washing my hair or face & it still persists. Elidel is the last in a long line of treatments: Bactroban, .05% Cutivate Cream, Desitin, Hydrocortisone etc. To me, this seems more RASHY than it does Eczema. Is there a possibility all of this being a fungal infection? Sometimes it will totally just go away for a few days, before returning almost instantly & fully. I'm using nonallergy detergents, nonallergy pillows, good bedding, not letting my dog on the bed, etc. I feel like I have crossed all my t-'s & dotted my i's with this, and I still keep having the facial rash. My doctor & dermatologist have not done skin scrapings & insist it is contact dermatitis. I have never had skin problems until after having the allergic reaction to the Zithromax antibiotics. One footnote. I have been living in Montana serving in the military until a year ago. My Dr. thinks the change in environments moving back home to Texas have been a factor in my facial rash/eczema. But since I've had so many inccoculations I am worried I might have Stevens Johnson Syndrome. I've been tested for HIV,w/ a neg result. Please advise.
Doctor's Answer
by Alan Rockoff, MD, Nov 05, 2003 12:00AM
, Nov 05, 2003 12:00AM
Your description is consistent with eczema, not fungus. Eczema comes and goes, is indeed "rashy," and fluctuates with no pattern. Environmental matters (food, soaps) rarely contribute in a meaningful way. I cannot make any sense of your post-Zithromax episode.
In my experience, Elidel doesn't work very well for extensive cases like yours. A key is to have a large enough supply of a topical steroid cream, so you can put it on wherever you need it. I suggest you ask your doctor about prescribing a one-pound jar of triamcinolone cream 0.1%
You may well find that condition takes long breaks and leaves you alone. Why it does that is anyone's guess.
Eczema is generally hereditary. Ask your family.
Best.
Dr. Rockoff
In my experience, Elidel doesn't work very well for extensive cases like yours. A key is to have a large enough supply of a topical steroid cream, so you can put it on wherever you need it. I suggest you ask your doctor about prescribing a one-pound jar of triamcinolone cream 0.1%
You may well find that condition takes long breaks and leaves you alone. Why it does that is anyone's guess.
Eczema is generally hereditary. Ask your family.
Best.
Dr. Rockoff
Member Comments (2)
by Roveta, Nov 23, 2003 12:00AM
I too have almost continuous eczema. No personal or family history. Mine also began after a series of Cipro, followed by IV Cipro and something like Prednisone in hospital. I first noticed skin was raw wherever clothing touched skin. Also inside elbows and knees. That was ten years ago. Now all of my skin, from scalp to toes is permanently abbraided, first raw, then crusted, then pus, then bleeding, then to another shot of Decadron, Prednisone and Benadryl. It definitly followed recent flu shot; any bacterial infection; any viral infection, including HSV eruption; contact or inhaling dust mites; ingesting salicylates; ingesting susfonamides; and certainly others I haven't identified. Tacrolimus did work but no longer does. I wondered if, for some reason, I am no longer capable of riddind my body of toxins by otherwise normal means.
