Eczema Flare-Up or SJS Concerns?
I’m a 32-year-old male with a background of eczema outbreaks. Recently, I took PrEP on an as-needed basis, consuming three pills over two days in anticipation of a sexual encounter that ultimately didn't happen, so I discontinued the medication. During that weekend, I noticed some rashes appearing on my armpits and legs, the areas where I typically experience flare-ups, and initially dismissed them. However, starting Tuesday, the rash in my armpits escalated, showing blistering and peeling while expanding in size. On Thursday, I sought medical attention at urgent care where the physician prescribed Cephalexin and Valacyclovir. Unfortunately, I’ve now discovered a fresh peeling lesion on my buttock, and although the condition of the blisters in my armpit remains unchanged, they haven’t worsened either. Presently, I’m feeling fatigued and my temperature is at 37.5°C. Is it possible that this could be something more serious than a standard infection, such as a drug reaction or Stevens-Johnson Syndrome? Should I consider going to the emergency room? I will share images of the rash in the comments for reference.
Answers (1)
9/6/2025, 2:50:35 AM
OpenHealth AI
It's understandable to be concerned about changes in your skin and overall health, especially with the background of eczema and recent medication use. Your symptoms—blistering, peeling rash along with fatigue and a mild fever—warrant careful consideration, particularly to rule out more serious conditions, including a potential drug reaction.
Main Points:
- You may be experiencing either an eczema flare-up or a reaction to the medications you've recently taken.
- Symptoms like blistering and peeling, combined with fever and fatigue, could indicate a more serious issue like Stevens-Johnson Syndrome (SJS), which is rare but requires prompt attention.
Explanation:
Eczema flare-ups can sometimes lead to secondary infections, particularly when the skin barrier is compromised. The antibiotics initially prescribed should help if it's an infection. However, blistering and extensive peeling, especially with new lesions appearing, raise concerns about a possible drug reaction or SJS, which is a serious skin reaction that needs immediate evaluation.
Next Steps:
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Immediate Assessment: Given the development of new lesions and your symptoms, it’s crucial to prioritize your health. If you notice any signs of widespread rash, pain, difficulty breathing, or if your fever worsens, consider going to the emergency room right away.
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Monitor Symptoms: Track any changes in your rash, including size and appearance, as well as any new symptoms like swelling in your mouth or eyes, which could indicate a serious reaction.
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Avoid Irritants: Until you get a clearer diagnosis, refrain from using any potential irritants, including strong soaps or other skincare products, that could worsen the rash.
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Follow Up: If your symptoms stabilize without worsening, contact your healthcare provider for further evaluation as soon as possible. Be sure to inform them about all medications you've taken recently, including PrEP.
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Hydration & Rest: Make sure to stay well-hydrated and get plenty of rest to support your immune system while you're dealing with these symptoms.
This situation should not be taken lightly; err on the side of caution when it comes to your health. Let me know if you have further questions or need more specific information.
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