How to treat rash on back, shoulders, and chest that hurt after sweating?

Question

Hi doctor,

I have problems with this rash on my back, shoulders, and chest. They are small dots but feel bumpy to the touch. It itches or burns only when I sweat. They come and go but have flaky skin when they are not itching. They have not spread but only stay on my entire upper or lower back and chest. I used Benadryl and Caladryl lotion to try and help. So far, nothing has stopped them from popping up. I have had them for over two weeks and have seen my general practitioner, who ordered me a blood test to test all the possibilities. My blood test came back fine. I am healthy with no deficiencies. So he could not determine what the rash was. I have had hives, which usually appear all over my body. So he ruled out that, and I am not allergic to any food or medicine. I do not take any medication, and I have a very strict healthy diet that includes fruits, vegetables, and chicken that I have followed for years. I did not change body wash, nor have I changed any eating habits. I take showers twice daily and wash all my clothing and bedding regularly. Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

Please send the picture of the area where you area having the itching as by looking at the photo (attachment removed to protect patient's identity) it is easy to diagnose and manage. Fungal infection indeed is very problematic if it becomes recurrent. You keep these precaution in mind and follow it regularly. I would suggest do not keep the affected area wet. Use powder frequently to keep it dry. Avoid itching and do not scratch the affected area. Change the under garments as and when required. Do not apply any general or steroid cream like Betnovate (Betamethasone Valerate BP 0.122 % W/W), etc. Do not stop the medicine once the lesions get cured. Continue medicine for long time to completely kill the fungus causing infection. Avoid excessive sweating and wet cloths. Check diabetes and thyroid it is really recurrent even after proper treatment. Now treatment part, I would suggest using Ketoconazole cream and tablet Terbinafine (Terbinafine hydrochloride) 250 mg for two months or Terbinafine cream and tablet Fluconazole 150 mg twice in week for two months. For itching take Levocetirizine 10 mg twice in a day. Consult your specialist doctor, discuss with him, and take medicine with consent. Thank you.