Seeking Advice for an Unidentified Rash
I'm sharing this on behalf of a friend who has struggled to find answers on r/DermatologyQuestions. Background: 28-year-old male, healthy and on PrEP. Approximately five days ago, my friend developed a rash that has no clear cause. While it itches occasionally, it is mostly not bothersome enough for him to notice it all the time. The affected area feels slightly warm and resembles a sunburn when pressed. Initially, it was restricted to his inner thighs, but it has since begun to spread, reaching his calves over the last few days. He has been applying hydrocortisone cream regularly and taking Benadryl each day, but there has been no sign of improvement. During a visit to urgent care, the physician's assistant mentioned that this rash was unfamiliar to her and needed time to think. In the end, she admitted she did not know the cause and prescribed a topical fungal steroid cream, which he has yet to use. He included some images for reference: one showcasing the current state, one from two days ago, and another from the day the rash first developed. Any thoughts or similar experiences would be appreciated!
Answers (1)
4/4/2025, 10:10:45 AM
OpenHealth AI
It sounds like your friend is dealing with a concerning rash that's spreading and not responding to initial treatments, which can be frustrating. Here are the main points to consider:
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Nature of the Rash: The description indicates the rash could be inflammatory, allergic, or possibly fungal in nature, especially since it has responded minimally to topical treatments.
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Immediate Management: Since hydrocortisone and Benadryl haven't improved the rash, it may be beneficial to stop using those for a short period to assess whether there's a change in condition.
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Next Steps:
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Application of the Prescribed Cream: Your friend should consider using the topical fungal steroid cream prescribed by the PA, as it may help if the rash has a fungal component. It's often useful for inflammatory skin issues as well.
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Keep the Area Clean and Dry: Ensure the affected skin is clean and dry. Avoid tight clothing to reduce irritation and heat in the area.
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Monitor Changes: Keep an eye on the rash for any signs of infection (increased warmth, swelling, pus, or fever). If any of these occur, it would warrant urgent attention.
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Avoid Irritants: Encourage avoiding known allergens, irritants, or products that could exacerbate the condition (e.g., certain soaps, detergents, or lotions).
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Symptom Diary: Maintain a record of the rash's appearance and any associated symptoms (like itching, pain, etc.). This can help in keeping track of changes for future medical advice.
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Follow-Up: If there’s no improvement in a week of using the new cream, or if the rash worsens, it’s important to seek a follow-up appointment with a dermatologist for a more in-depth evaluation.
Encourage your friend to remain proactive while being patient, as some skin conditions can take time to resolve or require several attempts before finding the right treatment. Let me know if you or your friend need more information!
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