OpenHealth Q&A

Persistent Full Body Rash: A Prolonged Mystery

My mother, aged 60 and of average build (5'9", 150 lbs), along with her healthy lifestyle—no smoking, minimal alcohol, and currently on specific medications and supplements—experienced the onset of a mysterious rash during our trip to Turkey in December 2024. Coming from the USA and having no prior skin problems, this sudden issue has now persisted for several months despite consultations with multiple medical professionals. Below is a summary of her symptoms and treatments attempted thus far. **Symptoms:** - Initially appearing on her ankles, the rash has now spread extensively across her upper and lower arms, chest, neck, ears, back, shins, calves, chin, jawline, face, and abdomen. - The rash is accompanied by severe itching, particularly at night and during the morning hours. It often manifests as a sharp, prickling sensation, which is painful, yet no visible causes are apparent. - Sleep has become severely disrupted due to the discomfort. - Even with regular changes of bed linens, dark specks appear on her sheets, clothing, and sometimes even her skin. Occasionally, these specks are surrounded by faint red markings. The lint trap from the dryer also collects numerous specks. - Notably, while she showers, these black specks can sometimes be seen on the soap and seem to evade capture when attempted. - The rash worsens in warm conditions, such as heat from the weather, sun exposure, and hot showers, particularly noticeable during the evening and night hours. **Treatments Administered:** Since February, she has seen three dermatologists, two general practitioners, and a Travel Medicine Specialist, in addition to visits to two urgent care centers. The following treatments have been tried: - Two separate courses of antibiotics (May 5 and May 20), each spanning two weeks. - A two-week trial of Otezla, which showed no improvement (May 5). - Triamcinolone injections were administered twice (February 20 and May 5) without any positive outcomes. - A combination of Triamcinolone cream and ointment provided temporary relief from itching but lasted no longer than two hours. - Taltz injections in both thighs slightly reduced inflammation over a few days, but did not alleviate the prickly sensation or itching. - Oral Ivermectin proved ineffective. - Several applications of Permethrin cream had a short-term effect, alleviating itching for two days but then the rash returned intensely. - A similar pattern followed with Benzyl benzoate 25%, providing temporary relief before the rash worsened again. - Spinosad cream did not yield any results. - Sulfur lotion offered minimal relief from itching for a day or two but has since become ineffective. - Hydroxyzine HCL was not very effective for controlling itching or aiding sleep. - A temporary prescription for Xanax (five tablets) from urgent care on July 19 provided some relief for sleep over three nights. - A course of Prednisone taken from July 25 to July 28 ultimately exacerbated the rash, causing it to spread and become exceedingly itchy throughout the day. **Additional Context:** Since moving into a new home in November 2024, which previously housed a dog, she currently has no pets. - On July 16, 2025, an inspection for bed bugs and other pests was conducted. The exterminator found nothing after a thorough examination, which included disassembling beds and checking the attic. He treated the entire property for various insects to eliminate any potential issues, yet the rash persists unchanged. - From July 19 to July 21, following treatment, she utilized a flea trap near a night light for three continuous days and nights; however, no pests were detected. **Medications Currently Taken:** Liothyronine and extended-release potassium (twice daily). **Supplements:** Vitamin C, Vitamin D/K, B complex, methyl B12, ferrous sulfate, magnesium glycinate, a probiotic, and krill oil. During our travels throughout Turkey, we visited numerous locations including Istanbul, the Gallipoli Peninsula, Troy, Ephesus, Kusadasi, Pamukkale, Antalya, Konya, and Cappadocia, engaging in various activities along the way. I appreciate any assistance and welcome inquiries for more detailed information, such as blood test results. Her current list of medications and supplements will be provided in the comments section.

Answers (1)

7/31/2025, 7:02:16 PM

OpenHealth AI

I can understand how distressing your mother's prolonged rash and intense itching must be for both of you, especially after trying so many treatments without lasting relief. It's clear that you're seeking a resolution to her discomfort, and I am here to help outline some potential considerations and next steps.

Main Points

1. Consider Allergic Reactions or Contact Dermatitis: The sudden onset and extensive nature of the rash, coupled with the itchiness and the described dark specks, may indicate an allergic reaction or contact dermatitis, possibly related to environmental triggers encountered in Turkey or in her new home.
2. Investigate Potential Infestations or Environmental Factors: Given the presence of mysterious specks and the former presence of a dog in her home, explore the possibility of other pests or allergens that might not be apparent through standard inspections.
3. Skin Care and Symptom Management: Focus on gentle skincare and immediate options for itch relief as further investigations are conducted.

Explanation

The wide distribution of the rash, with symptoms worsening in heat and moisture, might point towards an allergic response to something specific that she either came into contact with during her travels or something new in her environment, like allergens or irritants found in her home. The dark specks are unusual; they could be related to various factors, including fungal elements or something from the environment (like mold or dust particles).

Actionable Next Steps

1. Skin Care Adjustments:

   • Use a gentle, fragrance-free cleanser and moisturizer to avoid further irritation on her skin.
   • Consider using cold compresses or oatmeal baths to help alleviate itch and inflammation.

2. Detailed Environmental Assessment:

   • Even though an exterminator found no pests, consider performing a thorough cleaning and inspecting for mold or dust commonly found in newly acquired homes. Involving a specialist who handles environmental allergens might be worth exploring.
   • Look into various environmental allergy tests to check for sensitivities to things like dust mites, molds, or other allergens.

3. Track Symptoms and Environmental Changes:

   • Maintain a daily symptom diary, noting times when the rash worsens, any new products used, changes in the environment, and relief measures taken. This could help identify potential triggers.
   • Investigate her current medications and supplements for possible interactions or side effects that might contribute to the rash.

4. Explore Alternative Treatment Options:

   • Discuss with her medical providers the possibility of trying antihistamines that may help with itching, such as diphenhydramine (Benadryl) at night, or topical anesthetics but be cautious of potential reactions.
   • If over-the-counter treatments are ineffective, further consider a reassessment of her medications, specifically focusing on switching away from those that track systemic side effects.

5. Specialist Referrals:

   • Request a referral to a dermatologist specializing in chronic skin conditions or allergists experienced in polymorphic light eruption or other dermatological conditions that can present like this.

I encourage you to maintain close communication with healthcare providers, as persistent rashes can require a tailored approach to identify and address the underlying cause effectively. Continue to be vigilant, and please feel free to share updates or any additional questions you have as your mother navigates this condition.