What is this? blistery/bumpy/flakey rash on my face? HELP PLEASE

[kay2323]

Hi I am currently 25 years old and I have always had decent skin with the occasional period or stress related breakout however for the past 8 months I have been struggling with this persistant rash that won't go away.  The "rash" started on my forehead in two spots and appeared to be dry, peeling, or scabbing skin (not red scabs, just more white like dry skin).  After exfoliating and doing the same routine with face products and makeup the rash did not seem to go away, furthermore it began to spread... slowly but spread! Now it is basically all across my forehead, oh the corner of my mouth, and below my lip/chin area.  It has never spread to my cheeks! The rash seems to be a cycle starting with small blistery bumps that are definitely blistery not a pimple as there is nothing inside them, then turn to scabish dry patches.  if I exfoliate it gets red raw adn then the cycle begins again.  If I leave it alone the scabish dry bumpiness never never goes away!  Some past relevant history: I recently got diagnosed with celiac dieases, but do not eat or use any products with gluten in them; i have always used the same brand of makeup, however switched after a few months into the rash to using hypoallergenic/organinc/dye&perfume&gluten free everything; I was on Yaz birth control for the first time but went off of it in sept, so it has almost been a year not on that and I am not on any birth control; I take no meds; I am not allergic to any food but thought that dairy, nuts, or sugar might be the problem but stopped eating that and it didn't get any better!  Exhausted adn frustrated I went to a dermatologist who was going to take a biopsy but didn't bc that week I had tried using an anti-itch cream with hydrocortozone in it so it would have thrown off the results.  She prescribed a steroid with helped some but only worked for a week and then elidiel which doesn't work at all.  I was told it was not DH bc I dont have this rash anywhere else on my body except my face.  Any thoughts to what it might be or things that could work would be greatly appreciated...as this is truly driving me crazy!
Thanks,
Kay2323

[Bhupinder Kaur, MD]

Hello,
I would rule out dyshidrotic eczema as your dermatologist is suspecting.Your response to steroid ointment supports this possibility.Eczema is a form of chronic dermatitis (rash).Allergic reaction is one of the important causes of eczema.
Diagnosis of skin allergies includes Skin ***** tests (pricking the skin with a needle or pin containing a small amount of the allergen ('***** Testing' or 'Scratch Testing'), Patch tests (by applying a patch to the skin, where the patch contains the allergen.)And RAST.Also a biopsy skin will be helpful in confirming the diagnosis.Pls get it done.

Hope it helps. Take care and pls do keep me posted on how you are doing or if you have any additional queries.Kind regards.

[jagesh50]

A polymophous light eruption flfils the clinical picture except that there is no history of light sensitivity.Of course DH has to be ruled out despite the face localization.Granulomatous rosacea needs to be considered too.A biopsy would differentiate these conditions.A photograph would help me to differentiate from here though not with absolute certanity.