Facial Rash

[nikibaba]

History: 34/Male born and raised in Mumbai,India
I came to Canada in 2007 and recently first I was in Totonto, Ontario for 2 year then I moved to Calgary,Alberta and now back London,Ontario in June end. Weather wise Ontario is good, it is hot and humid similar to Mumbai and Calgary was very cold and dry.

2 weeks ago I started developing a rash on my forehead and right arm, nothing on the left arm. This rash started growing slowly and is tichy with scales/flakes of skin. Initially I thought this is due to change in weather since I also have cold soares on lips but things are not healing with routine moisturizers and face wash. The facial rash is on forehead, cheeks nose and now on neck too. Chin and the areas below that is spared. Nothing on the torso.
I have started Cetrizine 10mg OD a week ago and things are stable but not great. I need to wash my face atleast 2-3 times in a day and apply a lot of moisturizer as it looks dry and flaky. Especially on clinic days it becomes a bit difficult to see patients all this happening to my self. When I touch my face it feels like my skin is made of "paper". I dont have any family history of any autoimmune disorders. No fever or arthralgia. No major changes in lifestyle apart from the place. No new soaps or detergents
I was in swimming pool 2 weeks ago for a couple of hours and everyone thought this is sun burns, but then now things should resolve. I use sunscreen regularly.

Dont know what is happening? Your suggestions are welcome
Thanks
Dr.Nikhilesh Patil MD
Radiation Oncologist.
London,Ontario, Canada

[nikibaba]

Hi,
Thanks very much for your help. Right now Iam improving with Cetrizine 10 mg OD and avoiding sun. Getting a Derm consult will take a lot of time.
Will try to find out what Iam allergic too. Till now I didn't have any after getting exposed to everything in Mumbai,India.
nikhilesh

[Bhupinder Kaur, MD]

Hello,
Thanks for posting on the forum sir. From the symptoms that you have mentioned, solar urticaria is less likely. It is the development of hives minutes after exposure to the sun, which resolve in less than 1 hour. As regards, chronic hives after sun exposure, then the diagnosis can be confirmed only after examination. Hence I suggest you to consult a dermatologist and get it evaluated from him.

I hope it helps. Take care and regards.

[nikibaba]

Thanks for advice, Iam myself a physician (Radiation Oncologist). Is there a possibility of Sun Allergy?
Nick

[Bhupinder Kaur, MD]

Hello,
From the symptoms the possibilities of seborrheic dermatitis and eczema skin need to be ruled out. Seborrheic dermatitis is a common skin condition that causes flaky, dry, white to yellowish scales to form on oily areas esp under the nose or anywhere on face. Eczema is a form of chronic dermatitis (rash).Allergic reaction is one of the important causes of eczema. Allergic reaction can occur to strong soaps, Solvents, chemicals, certain foods, food additives, plants, metals, cosmetics, even urine and faeces of some animals (dust mites).

Wash the areas several times with fresh water. Do not use any cosmetic products at the sites. You can apply some calamine lotion at the rash as it will help in soothing the skin. You can take some OTC oral antihistamine medications like Benadryl or Claritin and see if it helps.

For mild-moderate symptoms a topical steroids can be used. Also keep the face well moisturized. If the symptoms persist then please get an evaluation done from a dermatologist.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.