nose issue

[robbit13]

History: developed a sun allergy during a pregnancy 20 yrs ago. I had a false neg syph test and saw a derm that just said, you may develop a collegen related disease, but I see nothing now in your tests

In 2006 got a moderate sunburn on nose. I had a small area that was irritated. Of course being OCD, I have tried EVERYTHING to get rid of it. Let me say that I have no health insurance so I did not see a doctor at first. So anyway I tried vitamin E and the next thing I know my entire nose is red and peeling and bleeding in spots. So I go to a Dr and he says I have contact dermetitis and gives me a script for prednisone. IT WORKS! But of course I have to stop the script and wean off it. The stuff on my nose comes back. It is bumpy and red and the skin feels tight and it is painful. Can anyone help?

[Bhupinder Kaur, MD]

Hello,
Unless and until the diagnosis is confirmed treatment cannot be started. There are many treatment options for psoriasis, chief ones being cognitive behavior therapy, creams containing coal tar, dithranol (anthralin), corticosteroids like desoximetasone, fluocinonide, vitamin D3 analogues and retinoids and phototherapy and photochemotherapy. Psoriasis that is resistant to topical treatment and phototherapy is treated by medications that are taken internally by pill or injection. The three main traditional systemic treatments are methotrexate, cyclosporine and retinoids.

For seborrheic dermatitis, Topical antifungals and mild steroids are the usual treatment and combination of the two can be used to treat stubborn patches. Oral antifungal drugs and immunomodulators such as tacrolimus and pimecrolimus are used in very severe cases.

So you can discuss these treatment options with your dermatologist.

I hope it helps. Take care and regards.

[robbit13]

Thanks for responding so quickly. I have no insurance and therefore can't go to the Dr. Is there something I can try to settle this down if it is SD or psoriasis without a script? And is it possible to limited to my nose?

[Bhupinder Kaur, MD]

Hello,
From your symptoms seborrheic dermatitis and psoriasis also need to be ruled out. Psoriasis is a long-term (chronic) skin problem that causes skin cells to grow too quickly, resulting in thick, white, silvery, or red patches of skin. It is thought that psoriasis occurs when the immune system overreacts, causing inflammation and flaking of skin.

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.