Red Spots on Chest: Looking for Feedback

[Tabris]

A few weeks ago I developed some red spots on my upper chest area, centered mostly around the front of the shoulders and pectoral region. The red marks would look like tiny red acne lesions, but they did not respond to any of the acne medication that I tried to use on them (benzoyl peroxide, etc). The marks would spread more and more. They did not itch, they were not painful, and they did not come to a head. The individual marks would fade after about 4-5 days, but more of them would spread into new areas.

I went to see my general practitioner family doctor about the situation and she mentioned that it could possibly be a fungal infection, pityrosporum folliculitis. I did notice that when I used the sauna at my gym that the red marks got worse and worse. My doctor prescribed a course of ketoconazole (Nizoral) pills and recommended that I also use over the counter Nizoral shampoo as a body wash once a day. I am currently taking one 200 mg Nizoral pill once a day before I work out (apparently the Nizoral is delivered to the skin through sweat) and using the Nizoral shampoo as a body wash once a day in the morning, leaving it on for 5 minutes and then washing it off. I have been doing this regimen for over 2 weeks now.

I have seen absolutely no improvement in the condition. The condition has not gotten any worse, and I've stopped using the sauna, but there are still new red marks developing in the same area and the oral antifungal pills and shampoo body wash seems to have no effect at all.

Does anyone have any in put as to what else the condition could be? I was told by my doctor that there are two kinds of folliculitis, fungal folliculitis and bacterial folliculitis, and if my condition had been bacterial folliculitis, I should have seen some improvement from the anti-acne products I had used on my chest in the beginning, which I had not seen.

I would love to hear everyone else's thoughts. Thank you!

[Bhupinder Kaur, MD]

Hello,
Apart from folliculitis, pityriasis rosea is another possibility which comes to my mind although it is difficult to confirm anything without examination. Initially, a primary plaque, called a herald patch, is seen. Then it is followed by a distinctive, generalized rash 1-2 weeks later. The rash lasts approximately 2-6 weeks and is found in a Christmas tree pattern over the trunk and abdomen.
Topical and oral steroids are needed. Water, sweat, and soap may cause irritation and should be avoided in the disease. Topical zinc oxide and calamine lotion are useful for pruritus.
I hope it helps. Take care and regards.

[Tabris]

Any feedback from any one on this forum? I am going on 3 weeks now - the red marks on my chest have been disappearing finally but the ones on my forehead are actually getting worse. Any feedback?

[Tabris]

Any thoughts on this issue?