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Suggest Medication For Severe Rashes On Forearm And Back While On Erythromycin

Posted on Thu, 7 Jan 2016

Question: Diagnosed with cellulitis and/or urticaria. Prescribed 400 mg Erythromycin ETH twice daily. No improvement, on day 3 switched to SMZ-TMP 800-160MG twice daily. On 4th pill now. Have seen no improvement in severe rash on both forearms, both calves, lesser on entire back. Rough, raised rash, not smooth and shiny like cellulitis nor whelp you like hives. Confused. Was on Keflex 500MG qid for 3 days immediately prior to this diagnosis. Healthy, active 62 year old female 125 lbs 5'4"

Answered by Dr. Dr. Muhammad Sareer Khalil (1 hour later)

Brief Answer:
Urticarial rash more likely

Detailed Answer:
Hello and Welcome

I appreciate your concern

Based on the description that you gave with respect to the rash, I have my doubts about cellulitis. The distribution of the rash fits urticarial rash. Anti histamines like desloratidine and/or levocetirizine can be advised. For initial extensive flare, hydroxyzine would be a better choice. If appropriate, you may upload some images of the rash to confirm the suspicion.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

Dr. M.S. Khalil

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Muhammad Sareer Khalil (12 hours later)

Hi, I have provided some attachments. Please review them.

Answered by Dr. Dr. Muhammad Sareer Khalil (18 hours later)

Brief Answer:
Explained

Detailed Answer:
Hello again.

Thanks for uploading the images. Based on the images you uploaded, Its not Cellulitis.

Urticarial rash, drug eruption are much more likely. Antihistamine and corticosteroid shot can be done in the ER e.g avil (pheniramine maleate) plus dexamethasone shot which can be given IM or IV based on the severity of symptoms. If its an allergic response , the rash will resolve completely within half an hour. Anti histamines can then be advised for 3 to 4 weeks.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

For future follow up / correspondence you may ask me directly at the link given below

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107

Dr. M.S. Khalil

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar