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:
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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.
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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.
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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.
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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.
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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!
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