
Have A Red Rimmed Lesion On Back Of Neck. Not Cured By Steroid Ointment. What To Do?

Thanks for writing in.
The condition you are suffering from can be vasculitic condition,scrofuloderma,infected lymph node ,leishmaniasis etc.
History of CREST and Sarcoid goes in favour of vasculitic ulcer.Also it can be infected lymph node with sinus formation .Scrofuloderma is a type of skin Tuberculosis that starts in neck region with discharging sinus and underlying lymph node breaking on the skin.
Also I would like to know-
Do you have fever or any other systemic complaints?
Do you have underlying lymph node in the neck which are palpable?
Are you on any medication like steroids?
You had any lesions of sarcoidosis on the skin?
You have any other skin lesions at present?at other sites?
Can you upload the photographs of the affected area?Photos can help a lot in predicting the condition.
Upload the photographs and we can continue the discussion here.
I will be available for follow up.
Hope this helps.
Regards.
Dr Sudarshan
MD dermatologist.


Thanks for the details and the photos.
After going through your reply it appears to be lesions of sarcoidosis .
Sarcoidosis can cause this type of lesions in scalp.
The ideal treatment for it would be oral steroids.As per your history you cannot take steroids.In this case the treatment can be antibiotics like minocycline for few weeks(3-5 weeks).Also steroid sparing agents like azathioprine,cyclosporine ,cyclophosphamide can be given.
Over the counter preparations of steroids can be tried for hand and scalp lesions.
Also intralesional steroids can be given in scalp if you cannot be started on oral steroids.Also good quality moisturizer containing urea and lactic acid can be helpful.
hope this helps.
I will be available for further follow up.
Regards.


The betamethasone is also a steroid ointment .It is a correct treatment for sarcoidosis.You can continue using it once a day .Also you can apply a good moisturizer with aloe and XXXXXXX butter it will help a lot.
I will be available for follow up.
Regards
DrSudarshan

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