Have Rashes On Trunk, Neck And Legs. Turns Dark Black At Center. No Itching. What Could These Be?
Thanks for writing to us.
From the images attached and description provided, I could think of two possibilities
Erythema multiforme( EM)
Fixed drug eruption(FDE)
EM occurs as small red bumps which enlarge to form central dark areas surrounded by a pale area which is finally limited by a red border. It is usually caused due to any viral infection or drug intake. Sometimes there is a preceding history of sore throat or flu like symptoms. These might involve mucosa like eye, genital area or oral cavity.
Fixed drug eruption occurs due to intake of any particular drug and is characterised by a red lesion with purplish centre.
Treatment in both the cases is application of steroid cream and a course of oral steroids.
I would advise that you XXXXXXX your dermatologist as early as possible to get the diagnosis confirmed and start the treatment.
In the meanwhile, you may apply steroid cream and calamine lotion to soothe the skin.
I would like to know, if there was history if any infection or drug intake prior to appearance of lesions.
Hope that answered your query.
Take care
Thanks for writing back and accept my apologies for delayed response.
Firstly as these lesions are not allergic so doubling the dose of cetirizine would not help.
Erythema multiforme can occur without any obvious known preceding cause ie can be idiopathic.
EM or FDE both may require time to resolve with steroid creams. At least a two week time is required.
Selenium sulphide shampoo would not help in resolution of lesions and can be discontinued.
A dermatologist's visit is required for clinical examination of the lesion. A biopsy may be required to confirm the lesion. As there has been no preceding cause, one can also think of EM like pityriasis rosea lesions in your husband's case. These are self resolving lesions and need only calamine and steroid cream application. So as far as my clinical experience goes I would have thought of a skin biopsy with EM, FDE and EM like pityriasis rosea lesions as differentials.
Kindly get an appointment with your dermatologist and in the interim continue with steroid cream.
Hope that helped you. Should there be a further query, please write back. Once you visit your dermatologist, do let me know what was his opinion.
Regards
-XXXXX
If there is a delay in getting an appointment, continue with prescribed steroid cream and calamine lotion. However keep a check on development of new lesions. If the lesion do not seem to fade away in a week or two or if there is involvement of mucosa( eye, oral cavity, genitals) or if the lesions keep on increasing in number then in that case do insist for an urgent appointment.
Hope that helped.
Wishing your husband a speedy recovery.