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Unknown Rash!!
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Unknown Rash!!

Need some suggestions.First off, I am 36, never had any skin conditions and nothing in the family. I am an active health nut and work out every day. Second week of july developed three redish to purple surface spots on left side of my hip.  Within a week a few more spots spread onto the right hip and up splotchy in the hip area.  By the third week, few more spots in the hips and on the rear end.  There also started to be some developement of rash symptoms right under the arm pits on both sides.  By the 4th week, the inner thighs were developing the rash.  Saw derm doc one, he thought it might be heat rash, perscribed antibiotic and cortisone cream for week.  No results.  Went to another derm doc for second opinion.  Rash a little more intense by this point. He did biopsy.  Just came back as a type of dermatitis casued by drug eruption or virus exathem.  I wasn't taking any drugs but was taken several vitamin supplements and few herbs.  Told me to lay off everything for 6 weeks and come back for update.  By week 4 no improvement and getting more irritated and had some areas in fore arms get some splochs.  Went back to first doc, he decided to try prednisone.  Wow, things were going away, but by day 10, came back and seemed to be worse.  After dealing with this for almost 2 months, decided to go to well know university for more advice because by this time, I was bothering physically and mentally.  Saw a derm doc who has been practicing for 30 years.  He took a look at me and within 5 minutes said it looked like an Allergic contact.  he asked me if I was using tide, which I had started probably 4 or so months ago. Never used it before. Asked If I also used dryer sheets, yep.  I told him I also used those body sprays. He was convinced that this was the problem. He also brought in another collegue to confirm who also does their pathology, he agreed.  Told to use woolite, 100% cotton, no soaps, hypo everything and probably shouldn't sweat for a while.  He also gave me 6 day predisone to start the healing and cortisone cream.  Don't use any lotions either.  I bought new sheets, and even some new 100% clothing and put myself in a hypoallergenic bubble.  By day 3 I thought this was it. I can't believe the other docs didn't ask these questions.  However, by day 9, things looked to be coming back.  Sure enough, they did. Went back to the doc, he was still convinced by his diagosis, decided to due the patch test, it came up negative.  Had the ana test and chem test, it came negative.  Did more blood tests, cbc, chem panel, urine analysis, etc. Everything came back negative or normal. Continued the course of hypo and cortisone cream, thought things were getting better but after a month of this, still hanging around. Had a third doctor at the university who does more of their patch testing look at and also concluded it was something of contact. They want to do more kinds of patch testing. Just can't figure out what I am coming in contact with. Continued
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The best I can say is that you have dermatitis (eczema).  Trying to correlate this with soaps and detergents nearly always fails.  In any case, you've done the biopsy, the patch testing, the trial of oral and topical cortisones, all of which point to a dermatitis.  Many of these cases are not environmental but genetic.  You may well not know anyone in your family who had it, because lots of people have it as kids, grow out of it for years or their whole life, and don;t remember they had it.

Bottom line: treat the symptoms when they're there and other wise ignore it.  Am I saying that no cause can be found?  Yes, indeed.  That is a bit frustrating but not as frustrating as chasing after correlations that don't stand up.  You've already done more than ordinary due diligence, seems to me.  I wouldn't be surprised if the rash just stops and leaves you alone after a while--happens all the time, though of course it may come back some day.  Meantime, use of of the treatment creams you've gotten that helped, and don't worry about it--it's just an annoyance.

Best.

Dr. Rockoff
3 Comments
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I am a very routine guy and nothing new in my life at that time.
Very baffeled.  Looking to see an allergist next.  Also wanted to note that my back and stomach/chest area seem more senstive and my chest and stomach seem to have more of a redish tent I guess due to the inflamation (inflammation) of the skin.  After 4 weeks of cortisone cream, have stopped for the time being, not really helping much and just masking if we haven't found the problem.  Not to mention skin is very dried out and becoming irritated.  
Anyone have any suggestions for trying to moisten the skin now that it drying and flaking?  Thanks for everyones time.

Rob
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Thank you Dr. for the response.  Curious as to what type of lotion if any I can use on other parts of the body that might be somewhat hypoallergenic?  With the cold season coming up, I am starting to dry out.  I haven't put anything in the last 2 months on my body while the doc's and I were trying to figure out what contact ingredients might be causing the rash.  I now think that since I have been so hypoallergenic and 100% cotton boy that it really doesn't matter.  I know my doc tells me to use white petrolatum(vaseline).  But it seems so none absorbing feeling.  
I had thought about using Pure aloe vera gel that you drink.  The reason is its 99.9% pure, no added water and it only has 1% citric acid and 1% carrageenan, which is a type of seaweed used for thickening.  I suggest this because it seems like more topical aloe still has some funky ingredients in there.  This just seems to be the lightest and purest.  Any input would be great.  

Thank you,
Rob
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