red facial rash

About a year ago I developed an itchy red line above my upper lip. Doctor prescribed triadcortyl cream which got rid of it for some time. It began to recur getting bigger each time and each time the cream lasted less time.Finally decided to see a doctor again when the rash was recurring every couple of days and covered whole of upper lip area, plus lips and starting to welt on bottom lip. Referred to dermatologist. Diagnosed perioral dermatitis. Tetracycline - allergic reaction. Prednisone for 10 days. Rash disappeared within a day of treatment - recurred worse than ever day after stopping. Now trying anti-fungal Lamisil oral. Rash seems to get better at night after pill but very dry, red and itchy during day. Lamisil cream horrible - causes severe burning and itching. Daktarin oral gel provides relief. Have another appointment with dermatologist in 2 weeks but am now emotional basketcase because of itching, dryness, tightness etc. Itch not constant but keeps recurring. Rash is red,sometimes with white scaly skin(when dry)sometimes very itchy, sometimes not, some patches are oval with crusty bits on them but not all the time, it doesn't seem to be spreading any further, seems to clear up and then flares up again - I'm at my wits end!! Could it possibly be seborrheic dermatitis or Tinea or perioral dermatitis? What do you think? Skin feels rough to the touch.

Thanks so much

[Alan Rockoff, MD]

I believe that you have perioral dermatitis, as the dermatologist said.  The proper treatment is one of the tetracyclines.

As to the "allergic reaction," I am skeptical for two reasons: 1) I have seen gastrointestinal and other side-effects to the cyclines but rarely if ever in all the years have I seen a true allergy to them; 2) Even when present, allergies do not require 10 days of prednisone.

Prednisone and the other steroids you have use worsen and perpetuate the rash, causing rebound.  Lamisil is irrelevant.

Suggestions: 1) Stop steroids and antifungals.  2) Get yourself on to a different antibiotic as recommended by the dermatologist, as well as a topical antibiotic like metronidazole.  3) Don't panic, please.  This condition is a reversible annoyance only.

Best.

Dr. Rockoff

[rory]

Hi... i have similar symptoms, except i get a rash all over my back up my legs on my arms and the back of my hands, tiny pink lumps that drive me nuts.
The rash on my face is very blotchy and under the skin kinda looks like linked pink flat spagetti pasta...with a dry scaley type rash on the surface that is covering 1/4 of right face cheek.
I have alot of pain under my right ribs,from under my right nipple to the very bottom of my rib cage. ..it hurts to bend over or press on the area...... lots of nausea and im very very ghostly pale this adds to making my rash noticeable...also ive begun sleeping about between 9 - 16 hrs a day because my energy levels have suddenly depleted, and i tire quickly.
I have no idea whats causing my body and face rash's etc nor what causes my under rib pain ..etc

just wondering if its all related or if i have a simple bacteria problem.

[zoozy]

A related discussion, Ms Susan Spill was started.