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What Causes Small, Red And Scaly Papules On Abdominal Region?

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Posted on Wed, 3 Jun 2015
Question: Was diagnosed with guttate psoriasis but indont think that is what i have. Worried its petechaie or HS purpura
doctor
Answered by Dr. Dr. Kakkar (6 minutes later)
Dear XXXXXXX its difficult to say without looking at it. Please visit another dermatologist to confirm the diagnosis. Hit a thanks. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (0 minute later)
Wondering what this might be! I was diagnosed with guttate psoriasis at a walk in clinic but i think they are wrong. Was on pencillin. Less than a week later covered in spots that have gotten progressively worse. Worst areas are both sides of my abdomins and the back if my right leg. They are not painful nor itchy .
doctor
Answered by Dr. Dr. Kakkar (17 hours later)
Brief Answer:
I request another clear Image; possibility of either guttate psoriais Or LP

Detailed Answer:
Hi.

Thank you. I have reviewed the Images.

Unfortunately the image of abdomen is not very clear. It is blurred and its hard to make out lesional morphology.
However, I could see the lesions on leg. They are grouped, shiny, reddish-purple, non-scaly.

I would like to keep another possibility of Lichen planus (LP).

This seems unlikely to be due to Henoch Schonlein purpura in which the lesions are mainly concentrated on dependent body areas/ lower legs.
There is usually pain & burning sensation associated with purpuric spots. There may be associated abdominal pain as well as joint pain in HS purpura.

This goes more in favor of guttate psoriasis. Lichen planus (LP) is another possibility but usually Lichen planus is very itchy.

Can you upload a cleared Image of skin lesions on abdomen?

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (4 hours later)
Hi. I cant seem to send pics on the app so i will send via email. Thanks so much for the response back. XXXX
doctor
Answered by Dr. Dr. Kakkar (5 hours later)
Brief Answer:
Either Guttate psoriasis Or Lichen Planus

Detailed Answer:
Hi.

I have reviewed the Image. It is very clear this time.

I can see small, red, scaly papules in this Image.

I will definitely keep a possibility of either guttate psoriasis Or lichen planus. Lack of itching is what goes more in favor of guttate psoriasis.

This is certainly not HS purpura.

I suggest an Oral antibiotic e.g Tab Erythromycin 500 mg thrice daily, for 2 weeks.
Topically you may use a mid potent topical steroid e.g either mometasone furoate 0.1% Or triamcinolone acetonide 0.1% cream, twice daily.

An OTC Oral antihistamine e.g cetrizine 10 mg once daily will provide you symptomatic relief from itching.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (23 hours later)
Thanks so much for hour help and advice. I am going to see my fsmily dr tomorrow so this is great information to have as i am hoping to get a referral to a dermatologist. That could take weeks oe months. Is there anything that would make you prefer one of the conditions over the other. Again thank-you!!
doctor
Answered by Dr. Dr. Kakkar (1 hour later)
Brief Answer:
Lichen planus is my first diagnosis; psoriasis is a close differential

Detailed Answer:
Hi.

I will keep lichen planus as my first diagnosis. However, psoriasis is a close differential diagnosis looking at the Images.
Lichen planus (LP) is usually itchy. Lesions of LP are purple/ violaceous, smooth, shiny, scaly and distributed on legs and torso.
Psoriasis usually also involves the scalp with scaly patches. Itching may be variable in psoriasis. It may be mild in some patients Or may be a prominent symptom in others.
Both these conditions respond to topical steroids.
Therefore you may use a topical steroid cream which I mentioned in my previous reply. You may try to find them over the counter, if possible till you can get an appointment.
Follow up with me after 2 weeks.

Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

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

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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What Causes Small, Red And Scaly Papules On Abdominal Region?

Dear XXXXXXX its difficult to say without looking at it. Please visit another dermatologist to confirm the diagnosis. Hit a thanks. Regards