Chronic Rash on Breast with Petechiae Development
I am a 23-year-old female from the UK, currently a student. My daily regimen includes 2.5mg of bromocriptine for a suspected prolactinoma, a condition that has led to non-obstetric galactorrhea. Additionally, I deal with anxiety and depression, and I am hypermobile. I take multivitamins regularly, do not smoke, consume alcohol infrequently, and maintain a generally healthy and active lifestyle. For approximately eight months, I've noticed a persistent redness on the lower inner side of my right breast. This area is not itchy, painful, warm, flaky, or elevated, which makes it somewhat tolerable. I don't believe it has significantly enlarged since I first saw it, although it occupies nearly that entire quadrant of my breast. Three years back, I experienced some undiagnosed skin issues, often described as atypical eczema, for which I possess a variety of steroid creams of different strengths. I assumed this rash might be linked and attempted to use these creams over the past few weeks; however, I observed no improvement. I also tried a topical over-the-counter treatment, enilconazole cream, but it yielded no results. In April, I consulted with my GP who prescribed fusidic acid and hydrocortisone for a few weeks, but again, there was no change. I subsequently used Trimovate cream, also without effect. Despite a holiday where I was exposed to sun and saltwater for a week, there were no noticeable changes. I have quite small breasts and typically don’t wear bras or form-fitting clothing, so I don’t experience friction or sweating in that area. Last week, I observed that the rash remained unchanged until around 7 PM. However, at 10 PM, I noticed a peculiar rash resembling petechiae appearing within the original area. I have not scratched or otherwise aggravated the skin. While the sensation remains unaffected, the development startled me. My GP was unable to examine me, and a phone consultation was limited in what could be addressed. She seems uncertain and is likely to refer me to a breast clinic. Fortunately, the rash has since subsided. I will include images of the rash from today and the recent changes in the comments for reference. Given that my doctor is unsure about the diagnosis, I would appreciate any insights or suggestions regarding what this might be and whether I should consider requesting further evaluations, such as biopsies. Thank you for your assistance!
Answers (1)
7/10/2025, 10:21:00 PM
OpenHealth AI
It sounds like you are dealing with a persistent and concerning rash that has evolved over several months. Given the symptoms you've described, it's important to consider several factors in understanding your situation better.
Opening Statement:
You’ve had a long-lasting rash with recent changes, and while it’s understandably concerning, there are potential benign explanations. However, continued evaluation is crucial.
Explanation:
The rash on your breast and the development of petechiae (tiny red or purple spots caused by bleeding under the skin) can result from various conditions, including dermatitis, allergic reactions, or even vasculitis. The area’s characteristics (no itching, pain, or warmth) may suggest it isn't an acute infection. The previous treatments you've attempted, like topical steroids and antifungal creams, may not have been effective if the underlying cause is different.
Your concern about the new petechiae is valid, especially in light of your medical history, including anxiety and depression, which can affect skin health due to stress. It’s important to rule out any serious underlying conditions, given the persistence and changes you've noticed.
Next Steps:
-
Document Symptoms:
- Keep a detailed diary of the rash, noting any changes in color, size, or sensation, as well as any potential triggers or connections to your diet, stress levels, or treatments. This can help your healthcare provider make a more accurate assessment.
-
Follow-Up with Healthcare Providers:
- Since your GP is already planning a referral to a breast clinic, follow through on that. Bring your documented symptoms and any images of the rash with you to aid in the evaluation.
-
Consider Skin Biopsy:
- If the referral leads to ongoing uncertainty, you might suggest a skin biopsy to definitively diagnose the rash, particularly if other conservative measures continue to fail.
-
Monitor Additional Symptoms:
- Be vigilant for any new symptoms, such as increased pain, swelling, fever, or worsening of the rash. If these occur, they may warrant immediate attention.
-
Self-Care:
- Continue using gentle skin care practices, like avoiding known irritants and using mild, fragrance-free cleansers and moisturizers.
Your commitment to your health and proactive approach to this rash is commendable. Remain open with your healthcare providers, and don't hesitate to ask for further evaluations if you continue to feel unclear about your condition. Let me know if there’s anything more specific you would like advice on!
Related Questions
Navigating Health Concerns: A Young Woman's Plight with Chronic Migraines and Stress
To summarize a very complex situation, last spring in 2025 was exceptionally challenging for me. I faced overwhelming stressors, including family deaths, eviction, and my parents splitting up. This turmoil led to chest pains so severe that I had to visit the emergency room because I couldn’t breathe deeply without experiencing intense pain. The doctors attributed the issue to psychological causes, but I continued to suffer from pain and instances of fainting due to the stress, which worsened as yet another family member was diagnosed with cancer. My psychiatrist suggested medication, and I started on Lexapro and Concerta, which improved my condition somewhat, even though I remained fatigued and felt like I was merely surviving. By the end of August, I contracted a severe case of bronchitis that caused me to experience fevers even while doing laundry. It seemed I was verging on pneumonia, prompting the prescription of prednisone and other steroid medications. Thankfully, I began to recover quickly, but soon after, I was plagued by persistent headaches and an overwhelming sense of paranoia that someone was out to get me. After another emergency room visit, the physicians informed me that, although my symptoms—such as fever, intense pain, night sweats, sensitivity to light, ear pressure, and a stiff neck—were alarming, they were likely just severe migraines that should eventually fade. Unfortunately, they didn’t. I returned to urgent care for further treatment, received antibiotics, and was advised to consult a neurologist. While the antibiotics provided some relief, my symptoms intensified. My primary care physician eventually prescribed sumatriptan, a medication intended to alleviate migraine pain, but instead, it exacerbated the headache. For the next two to four weeks, I endured an exceptionally difficult time, facing numerous strange symptoms that felt worthy of immediate attention, yet each visit concluded with a migraine diagnosis and a waiting period for my neurology appointment. My frustrations pushed me to contemplate risky alternatives for relief, but I resisted, feeling utterly hopeless and unable to cope. I sought an ear, nose, and throat specialist to rule out sinus issues, which turned out to be fine. A painful spot under my jaw led me to suspect nerve involvement, and I visited the emergency room again due to experiencing stroke-like symptoms (including mild left arm weakness, extreme headache, and minor speech issues). Sadly, I was again told it was merely a headache, and the IV medications were ineffective. During my annual check-up, my primary care provider was unfamiliar with my ongoing issues but discovered an enlarged lymph node in the lower left side of my neck and a cyst on my thymus after conducting a soft tissue scan. She reassured me that there was no need for concern and suggested waiting for my neurology visit or getting my eyesight checked. Despite my yellower complexion, increasing stiffness, and joint pain, I accepted her recommendation. While I mentally adapted to the chronic pain, which was always present, it affected my ability to concentrate and engage in daily life. I tried consuming plenty of lemon juice and engaging in lymphatic drainage massages, which provided transient relief and halted my yellowing skin. Now, in the present, I've noticed a peculiar, raised red bump on the side of my foot. It’s hard, tender, and smaller than a dime, without any accompanying rash. It has persisted for a couple of weeks without causing pain while walking. Additionally, more lymph nodes in my neck have become swollen, I have experienced difficulty swallowing, and I occasionally choke on air. My lungs feel heavier with a diminished sense of smell, though I don't have the thick mucus typical of a cold. The headaches, however, are reemerging, sharper than before, which is a concerning development. Throughout all of this, my blood pressure has remained within a low yet stable range, and my blood tests and CT scans have shown no significant issues. I haven’t consumed anything excessively that might raise concern, including food or drugs. Am I truly facing a serious health crisis? Should I prioritize getting another appointment, or do I need to rush to urgent care? I'm scheduled to see the neurologist in about a month, and I'm wondering if I should ask my primary care provider for some preliminary tests like blood work or an MRI beforehand. If so, what specific questions should I prepare for my neurology visit? I believe the pain has a genuine physical basis, although my anxiety definitely amplifies the experience.
Inquiry Regarding Metronidazole Use for Recurrent Bacterial Vaginosis
I am a 32-year-old female, measuring 5 feet 5 inches tall and weighing 248 pounds. My current medications include Vyvanse at a dosage of 40mg, a medication for asthma, vitamin D, a 325mg iron supplement, and as of now, I am also taking amoxicillin to treat strep throat. I am about to begin using Metronidazole 0.75% Vaginal Gel, with a total of 70 grams available. The instructions indicate that I should administer 5 grams vaginally twice a day for seven days, followed by twice a week for a period of two months. During the initial treatment phase when I will apply the gel twice daily, I anticipate abstaining from sexual activity. However, once I transition to the twice-weekly application, is it permissible to engage in sexual intercourse? I would normally consult my physician about this matter, but she is currently unavailable, and the nurse is also out of the office, which is quite frustrating.
Understanding Possible Seizure Triggers and Recurrence Risks
Health Background: I am a 21-year-old female, standing at 169 cm and weighing 65 kg. Over the past three years, I have been using oral contraceptives. As of this morning, I started taking 25 mcg of levothyroxine along with a weekly vitamin D supplement of 0.266 mg. Recently, I was diagnosed with hypothyroidism and found to have a vitamin D deficiency that I suspect has existed for the last three years. I do not consume alcohol or smoke, and I can confirm I am not pregnant. Two years ago, I experienced a mild concussion. I currently reside in Spain. A couple of months back, in mid-December, I blacked out twice. The second occurrence took place while I was at the doctor’s office after seeking urgent medical care for the initial incident. Following the second episode, I underwent a CT scan and an EKG, both of which returned normal results. Further tests, as directed by my physician, revealed a critical vitamin D deficiency and hypothyroidism; however, he expressed doubt that either of these conditions led to my loss of consciousness. I was then referred to a neurologist, and I am presently awaiting an appointment. Although the waiting period is lengthy, my doctor indicated that I should receive priority for scheduling, although the exact timeframe remains uncertain. The referral document summarized my events, labeling the second episode (which the physician witnessed) as a potential seizure devoid of tonic-clonic movements—a revelation that took me by surprise. After regaining consciousness, I felt extremely disoriented and terrified, struggling to process what was happening. I have no prior history of seizures, epilepsy, or any related conditions, and there is no known family history of these issues. If this indeed was a seizure, what might have triggered it? Additionally, what is the likelihood of experiencing another one? Since that time, I have not had any further incidents, but I have experienced moments where I felt a sense of impending doom, which I managed to overcome. I intend to wait for the neurologist's evaluation, but the uncertainty surrounding a possible neurological condition is quite distressing. Thank you for any insight you can provide!
INTENSE Spine Discomfort, Breathing Difficulties, Muscle Twitches, and Sweating
To elaborate on the situation mentioned in the title, I’ve been experiencing unusual muscle twitches and spasms for the past few days, along with some discomfort in my back. However, today, I felt an unexpected sharp pain shoot through my spine, which has left my legs feeling numb and made it impossible for me to sit up straight. Additionally, I’ve been dealing with cold sweats for the last hour and struggling to breathe properly. Perhaps I’m just overanalyzing things and it’s a common occurrence, but the intensity of the pain is overwhelming—it's truly unbearable. I’m shaking quite a bit, and unfortunately, my parents aren’t responding to my attempts to reach them for help. I have a history of a chronic heart condition and arthritis, yet I’ve never experienced pain this severe, especially in my spine. For context, I am nearly 15 years old and female. My current medications include pain relievers, anxiety medication, beta blockers, and some vitamins, though those specifics may not be particularly relevant. I don’t smoke; however, I have tried vaping a few times, which might not matter much, but I thought it was worth mentioning as it was requested.
Understanding Atrial Fibrillation and Thyroid Issues: Variability in Cardioversion Decisions
Hello everyone, I’m reaching out for guidance regarding my mother’s current health situation, and I’d greatly appreciate any shared experiences or thoughts. **My mother's background:** - **Age**: 55 years - **Weight**: Recently dropped to 116 kg from 118 kg in just two days, likely due to diuretics. - **Health history**: Previously an underactive thyroid, undiagnosed and untreated, now presenting as overactive. - **Medications**: Currently taking thyroid medication and a beta-blocker (Rapiblock). **Current health status:** My mother has been hospitalized since Tuesday, experiencing **atrial fibrillation with heart rates exceeding 200** beats per minute due to her thyroid's hyperactivity. - The plan for cardioversion was initially settled on Tuesday. However, the following day, the medical team advised postponing it until her thyroid levels could be stabilized, believing that her heart rate would return to normal once her thyroid condition was managed. - Her **obesity** precludes her from undergoing a transthoracic echocardiogram, and due to her thyroid concerns, she cannot handle contrast dye (this has been a consistent issue for over four years). Therefore, the only feasible option was a **transesophageal echocardiogram (TEE)**, which has yet to be performed. - She has been prescribed various medications including beta-blockers and thyroid treatments in the past. - On Friday, a doctor proposed proceeding with cardioversion; however, the attending senior physician objected. - Today (Saturday), another clinician has expressed a desire to move forward with cardioversion, having initiated a new medication, as the senior physician is unavailable. - **Communication has been unclear**, as we were notified of developments by a nurse rather than the physician in charge, causing confusion and anxiety. - Currently, only a **chest X-ray** is scheduled, and the TEE remains unaddressed. **My inquiries are as follows:** 1. Is it common for medical professionals to have varying opinions and frequently revise medication or treatment plans like cardioversion? 2. Is it safe to conduct cardioversion in the absence of a TEE? I presumed that this was a standard procedure to exclude the presence of blood clots. 3. Is it usual practice to have only a chest X-ray prior to moving ahead with cardioversion? 4. How typical is it for patients or their families to not be directly informed about treatment changes and learn about them through nursing staff instead? I recognize that this cannot substitute for professional medical advice. I’m simply trying to discern whether these circumstances are typical or if we should express our concerns more assertively with the healthcare facility. Thank you for your insights!