Seeking Insight on Prolonged Oval/Circular Rash
I am a 25-year-old female, weighing 163 pounds and standing at 5'8" tall. I have been prescribed Mycrogynon 20ED and I am currently taking Terbinafine, which is an oral antifungal medication. About six months ago, I developed a red, oval, or circular rash that initially appeared in the inner creases of my elbows. This rash later spread to other areas, including my neck, shoulders, wrists, and the back of my left knee. To address it, I was prescribed a 7-day course of steroids for what was suspected to be eczema. While this treatment was effective at first and eliminated the rash, it reappeared immediately after the course finished, and I noticed that the patches grew slightly larger while new ones also emerged. In December, my doctor extended the steroid treatment to 30 days, yet again, the rash temporarily disappeared before returning in January this year. Most recently, I've been on Terbinafine for the past two weeks due to the doctor’s suspicion that my rash may have a fungal origin. There were two significant events last September that could be relevant: first, we moved to a new room in our apartment only to discover mold on the blinds and windows, prompting us to relocate back to our previous room while searching for a new place; secondly, I sustained a deep scratch on the back of my left leg from a large dog. Since commencing the antifungal treatment, I experienced a purge during the initial three days wherein my skin turned extremely red, dry, and began to flake. Now, the rash has subsided somewhat and is no longer as vivid as it was before starting the medication. The doctor suggested I continue taking the Terbinafine for another two weeks to assess whether the situation fully resolves. However, I remain uncertain about the length of time this rash has persisted and what it might indicate.
Answers (1)
4/3/2025, 9:50:41 AM
OpenHealth AI
It sounds like you're dealing with a complex situation regarding a rash that has persisted and changed over time, and I understand how frustrating it can be. Here's a clearer overview of what might be happening and what steps you can take.
Key Points:
- Persistent Rash: Your ongoing rash could be due to various underlying conditions, especially considering your treatment history and potential mold exposure.
- Response to Treatments: While the antifungal medication Terbinafine showed some initial positive effects, the re-emergence of the rash suggests it may not be solely fungal or that there are underlying triggers remaining.
- Monitoring and Further Investigation: Understanding the rash's origin is important for proper management, especially in light of your past and current health treatments.
Explanation:
The rash you've described – which is oval or circular and has responded poorly to steroid treatments – could have different causes, including allergic reactions, fungal infections, or possibly something like psoriasis or contact dermatitis. The fact that it flares up after treatments suggest it could be related to either ongoing irritation from the mold exposure or an underlying condition that hasn't yet been identified.
Given your history and symptoms, lingering factors such as mold exposure or other allergens could be continuing to irritate your skin. Additionally, the deep scratch you experienced might have introduced a secondary infection, complicating the pattern of your rash.
Next Steps:
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Continue Terbinafine: Since your doctor has recommended continuing with the antifungal treatment for another two weeks, be sure to follow this advice. Monitor any changes in your rash's appearance closely.
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Hydration and Moisturizing: Keep your skin well-hydrated using fragrance-free moisturizers to help with dryness and flaking. This can assist in skin healing and barrier function.
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Identify and Avoid Triggers: If you notice that specific products (soaps, lotions, detergents) exacerbate your rash, try eliminating these to see if they contribute to your symptoms.
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Document Changes: Keep a journal of your rash – note where it appears, how it changes, and any products or foods you consume. This can provide valuable insights for you and your healthcare provider.
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Skin Care Routine: Develop a gentle skin care routine. Use mild, hypoallergenic cleansing products and avoid excessive scrubbing or exposure to potential irritants.
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Consider a Dermatology Referral: If the rash does not resolve after continuing your current prescribed treatment, or if it gets worse, consider asking your healthcare provider for a referral to a dermatologist. They can provide more specialized insights and perform tests if necessary.
I hope this helps clarify your situation, and I’m here if you have further questions or need more information about specific concerns. Take care!
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