Seborrheic dermatitis or not?

Hello, I am truly hoping someone can help me or guide me of where to look for help!  Approximately 6 weeks ago I developed a rash on my chin going up partway to my cheek it started one evening as just a reddend itchy area but by the next morning I had 52 small pustules on my chin  area that were somewhat itchy inflammed and very painful. I was on vacation and could not get into any dermatologist so I just treated it with caladryl. When I got home 2 weeks later the pustules were dried up but looked like small bright red acne scars. Prior to this rash I had been under alot of stress due to daughter requiring 2 emergency surgeries. I don't know if stress could have played a factor. When I saw the dermatologist she did not want to treat me for this area instead she wanted to first treat me for this other skin condition that she felt was seborrheic dermatitis. For the last seven years, onset was during my pregnacy with my twins, I have had a slightly reddend area that has somewhat of a hyper exfoliation to it. I have managed to keep this area not a problem by being extremely careful of what I use on my face. Most makeup ,face lotions  and some foods will exacerbate it and if something irritated itseverely evoclin gel woul calm it down although I would only use 1-2 treatment because it would burn. This new doctor put me on desonide lotion I used it for 4 days and each day my condition has gotten worse. It is now covering an area almost 4 time the original area, It physically is very painful even washing with cold water burns immensely. I can not use any makeup or my regular lotion. I started putting olive oil on it because it is extremely dry and this doesn't burn. My only other health issue is  polycystic ovarian syndrome.and recent weight gain. I do have a strong family history of autimmune diseases including Lupus and endocrine problems but do not have them myself. I am desperate for help between the scaring from the pustule rash and this new reddened area which  is now also above my lip an on skin by the medial side of my eyebrows but not extending into my eyebrows at all.I look so bad I try to avoid going out at all. Sun also irritates it. Please help?

[willy851]

It could be eczema or seborrhea dermatitis. It sounds like eczema. Desonide is a very low dose of steroids. Stress could indeed bring this on or exacerbate the situation. Their is no cure and no reasonable treatment. Steroids are the typical treatment but most can't be used on the face. Cetaphil or Vaseline will help. Apply a thick coat after shower. Try not to use soap on the area, it tends to dry the skin.
There are a couple of prescriptions that work for some people but they have black box warnings.

[Dr_Aparna]

Hi,
This sounds more like eczema rather than seborrhoeic dermatitis.Eczema is a form of dermatitis, or inflammation of the upper layers of the skin. The term eczema is broadly applied to a range of persistent skin conditions. These include dryness and recurring skin rashes which are characterized by one or more of these symptoms: redness, skin edema (swelling), itching and dryness, crusting, flaking, blistering, cracking etc.

Although it is an inherited disease, eczema is primarily aggravated by contact with or intake of allergens. It can also be influenced by other "hidden" factors such as stress or fatigue. This explains the flare-up prior to your daughter's surgery.

To combat the severe dryness associated with eczema, a high-quality, dermatologist approved moisturizer should be used daily. Moisturizers should not have any ingredients that may further aggravate the condition. Moisturizers are especially effective if applied within 5-10 minutes after bathing. This helps to lock in the moisture into the skin.

Corticosteroids have traditionally been considered the most effective method of treating severe eczema. Disadvantages of using steroid creams include stretch marks and thinning of the skin. Higher-potency steroid creams must not be used on the face or other areas where the skin is naturally thin; usually a lower-potency steroid is prescribed for sensitive areas. So Desonide would be the ointment for you to use.
ref:http://en.wikipedia.org/wiki/Atopic_eczema

I suggest that you first start with moisturizing the face and avoiding using any other soaps/face washes etc. on the face.
A non-soap cleanser can be used. Showers should be kept short and at a lukewarm/moderate temperature.
If these measures fail then you can think of applying the steroid medication.The immunosuppressant Tacrolimus or pimecrolimus can be used in the treatment of severe
cases instead of traditional steroid creams. However, there can be unpleasant side effects in some patients such as intense stinging or burning.

[wolfgirls]

Thank you so much for your response. Would some type of allergy testing also be beneficial? I have not narrowed the foods that flare it up although I think it is some type of preservative because it most often occurs when eating out. The redness will increase very rapidly after ingestion. Also even when I have had this area under control I am only able to use bare minerals make up, and cetiphil lotion .I Never try any other products because I have had increased irritation. Over the last several years I have never been able to wear sunscreen on my face as this causes more irritation. Thank you so much for your time and professional opinion.