circle rash

I am looking for guidance. Can you identify a resistant rash, which began on face composed of 5 white dots just below the surface of the skin and forms a circle. It is itchy initally only and it does spread.  
It flourishes with cortisone or any topical with flouride. Doxycycline,Doryx is not effective. Cutivate Cream seems to mask the condition while in use, but reappears once stopped. It appears to be spreading amoung a group of flight attendants, suggesting an enviromental cause. Is it bacterial?

[Alan Rockoff, MD]

Cynth:

I'm stumped, as apparently is your dermatologist.  I don't think I've ever seen a rash which has 5 white dots in a circle.

When you say that the rash is "spreading amoung a group of flight attendants," do you mean that they have the same thing--white dots in a circle?  That would truly be an amazing coinicidence, since your condition can hardly be bacterial.  If it were bacterial, it would spread first on you--outside the circle to the rest of your face, or body.

One possibility is that this is a form of eczema, because Cutivate (a steroid) masks it.  But white dots in a circle is hardly typical for that condition.

The white dots I most often see on the face are milia, or cysts.  They can be treated by being extracted with a sharp instrument, or else cauterized.  Perhaps you should ask your doctor about these modes of treatment.

Best.

Dr. Rockoff

[cynth]

DR.Rockoff, Yes indeed they have the same thing starting initally on face around mouth, one gal on leg. All have been flying to and from Miami, been on beach sand and in ocean.

Rash does spread but only in additional circles not all the same size. If bump is broken, clear fluid inside. Today I have it in my ear,between eyebrows,side of nose. Have been in contact with CDC, they are stumped as well.

Miami health Dept. has no info., however one passenger on 3/23 told us she is back in MIA cause her young boy  has a strange circle bump rash  on skin and they are going to the DR.

What next?

[Alan Rockoff, MD]

Sorry--I don't really have anything to add.

Dr. Rockoff

[Pandy]

Couldn't it be ringworm?

[lacekiah]

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[DeniseZ]

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