Upper Chest Rash - Should I Simply Monitor It?
Since March, I’ve been dealing with a pinkish-red rash shaped like a circle or an oval on my upper chest. When it initially surfaced, it was a bit itchy. At that time, a nurse practitioner at an urgent care facility suspected it was ringworm, so I followed her recommendation to use antifungal cream; however, the rash persisted unchanged. In my attempt to address it further, I applied hydrocortisone cream, yet the rash remained unresponsive. Consequently, I reached out to my primary care nurse practitioner via My Chart, and she prescribed Clobetasol Propionate 0.05%, a potent steroid cream, instructing me to apply it twice daily for a maximum of two weeks. Now, after three months, this rash has settled on my chest, featuring a slightly elevated and rough surface, but thankfully, it no longer itches. It measures approximately 5-6 cm across. The border on one side is well-defined, while the opposite side appears more faded and indistinct. Recently, I received notice that I am “no longer eligible” for my health insurance, which makes me hesitant to spend money on a condition that might not be serious. What course of action would you recommend? For your reference, I am a female, standing 5'5" and weighing 148 pounds. I reside in the northeastern United States and currently take Paxil 30 mg and Xyzal over the counter for allergies. My medical history includes anxiety, asthma, seasonal and indoor allergies, and a severe shellfish allergy.
Answers (1)
6/15/2025, 3:30:42 PM
OpenHealth AI
It sounds like you've been dealing with a stubborn rash for quite some time, and I understand your concern about whether it's serious or just something that needs monitoring. Given the details you've shared, here are some key points to consider and next steps you can take.
Summary of Main Points:
- Rash Overview: The rash has been persistent for months, hasn’t responded to antifungal treatment or hydrocortisone, and has remained stable without itching.
- Possible Causes: The characteristics of your rash (pinkish-red, circled shape, rough surface, well-defined border) suggest it may be a type of dermatitis, but a definitive diagnosis can't be made without a professional evaluation.
- Monitoring vs. Action: Given the lack of change despite treatment and its duration, further evaluation may be beneficial, especially if your insurance situation improves.
Explanation:
The rash you describe could potentially be something like eczema, psoriasis, or another type of dermatitis rather than a fungal issue, especially since it's been resistant to antifungal treatments. While the lack of itching is a good sign, the persistence and physical characteristics of the rash warrant closer evaluation to rule out any underlying conditions or to consider alternative treatments.
Next Steps:
- Monitor the Rash: Keep an eye on any changes in size, color, texture, or if it becomes itchy again. Note any triggers that may worsen it, such as stress, allergens, or products you use.
- Moisturize Regularly: Use a gentle, fragrance-free moisturizer daily to keep the skin hydrated. This can help in managing dermatitis.
- Avoid Irritants: Refrain from using harsh soaps and skincare products that could irritate the area further.
- Document Your Findings: Keep a journal of the rash’s appearance and any symptoms you notice—this will be helpful for future evaluations.
- Plan for Professional Evaluation: As soon as your insurance situation is resolved, consider visiting a dermatologist for a proper assessment. Conditions like psoriasis or other skin disorders may require different treatments and should be diagnosed accurately.
Conclusion:
While monitoring the rash can be an option for now, a professional evaluation would provide clarity and possibly more effective management. If any new symptoms arise, or if the rash worsens, seek medical advice sooner. Please take care, and keep me updated on your progress!
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